Men's Sexual Health in Bangladesh

Masculinities, generations and health:

Men's sexual health in Bangladesh

Md Kamrul Hasan

A thesis in fulfilment of the requirements for the degree of

Doctor of Philosophy

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Centre for Social Research in Health

Faculty of Arts and Social Sciences

UNSW Australia

• February 2017

• .. PLEASE TYPE THE UNIVERSITY OF NEW SOUTH WALES Thesis/Dissertation Sheet

Surname or Family name: Hasan

First name: Md Kamrul Other name/s:

Abbreviation for degree as given in the University calendar: PhD Faculty: Faculty of Arts and Social School: Centre for Social Research in Health Sciences

Title: Masculinities, generations and health: Men's sexual health in Bangladesh

Abstract 350 words maximum: (PLEASE TYPE)

Together, men, masculinities and health comprise an emerging area of research, activism and policy debate. International research on men's health demonstrates how men's enactment of masculinity may be linked to their sexual health risk. However, little research to date has explored men's enactment of different forms of masculinity and men's sexual health from a social generational perspective.

To address this gap, insights from Mannheim's work on social generations, Connel�s theory of masculinity, Butler's theory of gender performativity, and Alldred and Fox's work on the sexuality assemblage, were utilised to offer a better understanding of the implications of masculinities for men's sexual health. A multi-site cross-sectional qualitative study was conducted in three cities in Bangladesh. Semi-structured interviews were used to capture narratives from 34 men representing three contrasting social generations: an older social generation (growing up pre-1971), a middle social generation (growing up in the 1980s and 1990s), and a younger social generation (growing up post-2010). A thematic approach was applied to analysis to identify the key issues focused upon in men's accounts.

The analysis revealed generational differences and similarities in the construction of masculinity, in sexual practices and in help and health-seeking practices. Findings show that certain ideals of masculinity were common across all social generations. However, social, cultural, economic and political transformations in Bangladesh have produced significant cross-generational differences and discontinuities. Study findings point to the importance of understanding how the production and enactment of specific forms of masculinity are shaped by education, urbanisation, and globalisation, as well as by the cultural dynamics of religion (especially Islam), work, homosociality, patriarchy and heteronormativity, and how these in turn affect sexual health and health-seeking practices.

This thesis contributes to a socially located understanding of masculinities, gender and men's sexual health from a social generational perspective. It argues for the need to move beyond stereotypical, reductionist, essentialist and binary understandings of men, masculinity, gender and health in the South Asian contexts, highlighting opportunities for new forms of intervention and action to promote men's sexual health.

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Originality Statement: I hereby declare that this submission is my own work and to the best of my knowledge it contains no materials previously published or written by another person, or substantial proportions of material which have been accepted for the award of any other degree or diploma at UNSW or any other educational institution, except where due acknowledgement is made in the thesis. Any contribution made to the research by others, with whom I have worked at UNSW or elsewhere, is explicitly acknowledged in the thesis. I also declare that the intellectual content of this thesis is the product of my own work, except to the extent that assistance from others in the project's design and conception, or in style, presentation and linguistic expression is acknowledged.

Copyright Statement: I hereby grant the University ofNew South Wales or its agents the right to archive and to make available my thesis or dissertation in whole or part in the University libraries in all forms of media, now or here after known, subject to the provisions of the Copyright Act 1968. I retain all proprietary rights, such as patent rights. I also retain the right to use in future works ( such as articles or books) all or part of this thesis or dissertation. I also authorise University Microfilms to use the 350 word abstract of my thesis in Dissertation Abstract International. I have either used no

substantial portions of copyright material in my thesis or I have obtained permission to • use copyright material; where permission has not been granted I have applied/will apply for a partial restriction of the digital copy of my thesis or dissertation.

Authenticity Statement: I certify that the Library deposit digital copy is a direct equivalent of the fmal officially approved version of my thesis. No emendation of content has occurred and if there are any minor variations in formatting, they are the result of the conversion to digital format.

Signed: J\1,9, k~ WJJ f}ctgcrn Date: 17th April 2017

Md Kamrul Hasan

•

• Abstract

Together, men, masculinities and health comprise an emerging area of research, activism and policy debate. International research on men’s health demonstrates how men’s enactment of masculinity may be linked to their sexual health risk. However, little research to date has explored men’s enactment of different forms of masculinity and men’s sexual health from a social generational perspective.

To address this gap, insights from Mannheim’s work on social generations, Connell’s theory of masculinity, Butler’s theory of gender performativity, and Alldred and Fox’s work on the sexuality-assemblage, were utilised to offer a better understanding of the implications of masculinities for men’s sexual health. A multi-site cross-sectional qualitative study was conducted in three cities in Bangladesh. Semi-structured interviews were used to capture narratives from 34 men representing three contrasting social generations: an older social generation (growing up pre-1971), a middle social generation (growing up in the 1980s and 1990s), and a younger social generation (growing up post-2010). A thematic approach was applied to analysis to identify the key issues focused upon in men’s accounts.

This thesis contributes to a socially located understanding of masculinities, gender and men’s sexual health from a social generational perspective. It argues for the need to move beyond stereotypical, reductionist, essentialist and binary understandings of men,

ii masculinity, gender and health in the South Asian contexts, highlighting opportunities for new forms of intervention and action to promote men’s sexual health.

iii

Acknowledgements

I would like to express my sincere gratitude and thanks to my supervisor Peter Aggleton, UNSW Scientia Professor, and joint supervisor Dr Asha Persson, Senior Research Fellow, in the Centre for Social Research in Health (CSRH) at UNSW Australia. I am immensely grateful to them for their guidance, mentorship, comments and suggestions throughout the research process. But for their support, it would have been impossible to complete the thesis in time.

I would also like to thank the 34 men who participated in the study for their valuable time and contribution. Their rich accounts helped me to gain deeper insights into social generational masculinities, men’s sexual practices and help and health-seeking practices in the South Asian context.

I also thank Dr Christy Newman, former Postgraduate Coordinator and Dr Loren Brenner, Postgraduate Coordinator at CSRH for their support during my candidature. Dr Newman provided me with some of her papers about men’s health and social generations, which I found useful. I also had an opportunity to attend a Communicating Your Research workshop that Dr Newman co-facilitated.

I sincerely thank Professor Emerita Raewyn Connell at the University of Sydney for her comments on my research proposal. It was my honour to meet her and receive valuable feedback from a person whose work in part provided the theoretical ground and inspiration for my research. My developing understanding of gender and masculinity was largely shaped by Connell’s work on these subjects. She also provided me with some very useful references.

This research was made possible through an International Postgraduate Research Scholarship offered jointly by the Commonwealth of Australia and UNSW Australia. In addition, I received a top-up scholarship and funding for fieldwork from the Faculty of Arts and Social Sciences and conference funding from the Graduate Research School at UNSW Australia to present a paper in Switzerland.

My special thanks are due to Ms Ann Whitelaw, Ms Janice Knapman, Ms Catherine Zell and many others for their support during my candidature at UNSW Australia.

I am also grateful to a number of Bangladeshi universities and non-government organisations for their assistance in recruiting research participants for my study. Thanks are due to Ms Meheri Tamanna, Senior Lecturer, BRAC University and Professor Syed M. Hashemi, former Chairperson of the Department of Economics and Social Sciences, BRAC University, Mr Shahidul Hoque, Assistant Professor and Professor A. K. Enamul Haque of the Department of Statistics, University of Chittagong.

Among the non-government organisations that helped with recruitment and letters of support were the Bandhu Social Welfare Society (BSWS), the Family Planning Association of Bangladesh and the Bonoful Social Welfare Centre. I would also like to thank Mr Shale Ahmed, Ms Kamrunnessa Ferdousi, Mr Saiful Hasan, Mr A.B.M Abu Sayem and Mr Alauddin Shaikh for their assistance in recruiting participants to this study.

I would also like to thank Ms. Sharika Khan who translated and transcribed about one- third of the interviews.

I had the chance to talk at length with Dr K. M. Kabirul Islam who was a fellow PhD Candidate at Social Policy Research Centre (SPRC), UNSW Australia about our research, rules and regulation of the University. I found these conversations useful.

I attended several workshops conducted by the Learning Centre at UNSW Australia on thesis writing and research methods. I thank Professor Sue Starfield who facilitated workshops that I found particularly useful.

I thank Dr Leanne Dowse and Dr Jamie Roberts from whom I took Qualitative Research Methods and Developing Your Thesis Proposal courses, respectively. I received feedback on my research from both of them while taking the courses in 2013.

I thankfully acknowledge excellent editing of my thesis by Dr Wendy Sarkissian.

I thank my wife Ruma and little son Mrinmoy for their inspiration, love and support throughout my candidature. Ruma assisted me in checking the references.

Relevant publication

The following paper based on the research reported in this thesis has been published:

Hasan, M. K., Aggleton, P., & Persson, A. (2015). Rethinking gender, men and masculinity: Representations of men in the South Asian reproductive and sexual health literatures. International Journal of Men's Health, 14(2), 146-162.

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Acronyms

AIDS – Acquired Immunodeficiency Syndrome

BBS – Bangladesh Bureau of Statistics

BSWS – Bandhu Social Welfare Society

BSKS – Bonoful Samaj Kallyan Sanghstha (Bonoful Social Welfare Organisation)

BRAC – Bangladesh Rural Advancement Committee (now just BRAC)

CMNI – Conformity of Masculinity Norms Inventory

CF – Consent Forms

CSMM – Critical Study of Men and Masculinities

CSRH – Centre for Social Research in Health

EPZ – Export Processing Zones

GII – Gender Inequality Index

HIV – Human Immunodeficiency Virus

HREC – Human Research Ethics Committee

ICDDR, B – International Centre for Diarrhoeal Disease Research, Bangladesh

ICPD – International Conference on Population and Development

IPC – Indian Penal Code

MDG – Millennium Development Goals

MSM – Men who have sex with men

NGO – Non-governmental organisation

NIPORT – National Institute of Population, Research and Training

NHMRC – National Health and Medical Research Council

PIS – Participant Information Statement

SDG – Sustainable Development Goals

STI – Sexually Transmissible Infections

UNDP – United Nations Development Programme

UNFPA – United Nations Population Fund

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UNSW – University of New South Wales

WHO – World Health Organisation

Table of contents

Originality and copyright statement……………………………………………………...i

Abstract...... …………………………………………………………………………….ii

Acknowledgements...... ………………………………………………………………..iv

Relevant publication...... ………………………………………………………………vii

Acronyms...... ….……………………………………………………………………...viii

Table of contents...... …………………………………………………………………...x

Chapter 1: Introduction....……………………………………………………………..1

Research aims...... 1

Personal and academic underpinnings of the research ...... 2

Theoretical underpinnings ...... 6

Methodological approach ...... 9

Significance of the study ...... 11

Organisation of the thesis ...... 11

Chapter 2: Men, masculinities and health: literature review.……………………...14

Introduction ...... 14

Gender, men and masculinity ...... 14

Men, masculinity and health: international perspectives ...... 17

Gender relations in South Asia ...... 20

Men, masculinity and health in South Asia ...... 22

Men and masculinities in South Asia ...... 23 Masculinities and health in South Asia ...... 29 Masculinities and sexual health in South Asia ...... 32

Concluding remarks ...... 35

Chapter 3: Mapping the research journey..…………………………………………37

Introduction ...... 37

Philosophical foundations: ontology, epistemology and research strategy ...... 38

Ontological assumptions ...... 38 Epistemological assumptions ...... 40 Methodology: research strategy ...... 42 Theoretical underpinnings ...... 43

Connell’s theory of masculinities ...... 43 Butler’s theory of gender performativity ...... 45 Mannheim’s theory of social generation...... 47 Research design and method ...... 48

Research sites and setting ...... 48 Participant recruitment ...... 50 Semi-structured interviews ...... 52 The process of interviewing ...... 54 Making sense of men’s narratives: data analysis ...... 56

Ethical considerations ...... 59

A note on reflexivity ...... 61

Chapter 4: Making a man: generational masculinities..……………………………66

Three social generations ...... 66

Masculinities in older social generation men ...... 69

Masculinities in middle social generation men ...... 76

Younger social generation men’s masculinities ...... 82

Conclusion ...... 92

Chapter 5: Generational sexualities: patterns in men’s sexual practices………….94

Introduction ...... 94

Older social generation men’s sexual practices ...... 95

Middle social generation men’s sexual practices ...... 99

Younger social generation men’s sexual practices ...... 107

Implications for men’s self-understandings and for masculinity ...... 112

Chapter 6: Men’s sexual health and help-seeking practices ...... 114

Introduction ...... 114

Older social generation men’s sexual health and help-seeking practices ...... 115

Help-seeking practices ...... 115 Health-seeking practices ...... 119 Middle social generation men’s health and help-seeking practices ...... 123

Help-seeking practices ...... 123 Health-seeking practices ...... 127 Younger social generation men’s help-seeking and health-seeking practices ...... 131

Help-seeking practices ...... 131 Health-seeking practices ...... 135 Concluding remarks ...... 137

Chapter 7: Rethinking masculinities/gender and men’s sexual health: A social generational perspective .……………………………………………………………139

Introduction ...... 139

Rethinking masculinities, gender and sexual health ...... 140

Continuities and discontinuities across social generations ...... 140 Gender, masculinities and power ...... 144 Gender, masculinities and performativity ...... 146 The masculinity/sexuality-assemblages of different social generations ...... 148 Implications of masculinity/sexuality-assemblages for men’s sexual health ...... 154

Promoting sexual health ...... 157

Future research ...... 159

Some methodological reflections ...... 161

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References…………………………………………………………………………….164

Appendices…………………………………………………………………………...186

Appendix A: Interview Guide………………………………………………………..186

Appendix B: Participants' socio-demographic profile………………………………..188

Appendix C: Research ethics approval letter………………………………………...191

Appendix D: Participant Information Statement and Consent Form…………………193

Table

Table 1: The masculinity/sexuality-assemblages of different social generations…….150

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Chapter 1: Introduction

Research aims

This thesis seeks to provide a better understanding of men, masculinities and sexual health in Bangladesh from a social generational perspective. In South Asian contexts, gender has often been conflated with women’s issues and men have often been portrayed in a somewhat stereotypical manner in the available literature (Hasan, Aggleton, & Persson, 2015). To date, there has been little consideration of masculinity in Bangladesh, with some notable exceptions (Anwary, 2015). Drawing on the conceptual work of Karl Mannheim, Raewyn Connell, and Judith Butler, this thesis offers a more nuanced understanding of men as gendered agents, who often enact their masculinities in multiple and variable ways across different social generations, with particular focus on the implications of men’s enactments of masculinity for their sexual health.

This research is significant because heterosexual men’s sexual health remains a neglected area of academic inquiry, especially in settings outside the global North. Only relatively recently has research literature started to emerge internationally, demonstrating that men do encounter health problems arising from their location within the gender order. Although historically there was a small but much-talked about men’s liberation movement in the 1970s in Western countries (especially the USA and in Europe), men’s health has largely failed to attract the same attention from researchers and policy-makers that women’s health has. Furthermore, within reproductive and sexual health literatures, research and programmes, there has been a tendency to depict men solely as barriers to promoting women’s health (Mullany, 2010; Kamal, 2000; Hossain, 2003; Chapagain, 2005; Salam, Alim & Noguchi, 2006; Story & Burgard, 2012; Hou & Ma, 2012).

Research in the area of gender and health in South Asia has attempted to examine the influence of gender on, among other issues, health care utilisation, sex-selective abortion in India, the neglect of female children and life expectancy rates, which unusually have tended to favour men in several South Asian countries (Ahmed, Adams, Chowdhury, & Bhuiya, 2000; Fikree & Pasha, 2004; Roy & Chaudhury, 2008; Sen &

Iyer, 2012). Little research in South Asia to date has focused on men as gendered subjects, on masculinities or on men’s sexual health. To address this gap in the literature, this thesis aims to examine the implications of cultural gender ideologies and enactments of masculinity for men’s sexual health in Bangladesh. To achieve the aims mentioned above, the study is organised around the following three research questions:

• How, historically and culturally, are specific masculinities constructed and enacted by different social generations of men in Bangladesh? • What are some of the significant patterns of men’s sexual practices and behaviours across different social generations? • How do these enactments of different forms of masculinity influence and affect men’s sexual health?

Personal and academic underpinnings of the research

A variety of influences in my educational, professional and personal background drew me to the study of men, masculinities and sexual health. My interest in pursuing a doctoral study in a health-related field developed through my engagement with health, development, human rights, social justice and gender issues over a decade as a student, researcher, development worker and teacher. My interest was also shaped by my growing up as a man in Bangladesh, a country in South Asia, which required me constantly to negotiate, adhere to and resist forms of Bangladeshi, Islamic masculinity.

I grew up in Bangladesh at a time of great change, witnessing how rapid population growth led to overcrowded cities, slums, poverty, injustice, political instability, violence and social inequality. Historically, Bangladesh was an agrarian country and is now experiencing rapid urbanisation and industrialisation. The growth of the ready-made garment industry is one of the most important contributing factors to urbanisation. Bangladesh is relatively homogeneous in terms of language and religion, with most people speaking Bengali/Bangla and practising Islam. Bangladeshi or South Asian Islam is Sufi-influenced – Sufism being a mystical branch of Islam, which differs from Arabian Islam (Sondy, 2014). I have, however, observed that religious practices significantly differ across different regions and social groups in Bangladesh. While Sufism embraces peace, simple life, and tolerance, in recent years, Bangladesh has seen

2 the rise of religious extremism, with some radical Islamist groups killing “secular” bloggers, online activists and writers (The New York Times, May 8, 2016).

As a low-lying country with many rivers, Bangladesh commonly experiences natural disasters, such as floods and cyclones, frequently featured in international news headlines. Two World Bank economists in the aftermath of the 1971 War described Bangladesh as a “bottomless basket” and a “test case for development” (Khan, 2013), expressing pessimism about the country’s future. Over the last four and half decades, however, Bangladesh has dispelled such pessimism, making progress in areas of women’s empowerment, economy, health, education and disaster management (Zaman, 2005; Khan, 2013). This progress in a context of economic poverty is often referred to as the “Bangladesh paradox” (Chowdhury, Bhuiya, Chowdhury, Rasheed, Hussain, & Chen, 2013).

I first began to develop an interest in health and development while pursuing my undergraduate studies in sociology at the University of Dhaka, where I completed Bachelor of Social Science and Master of Social Science degrees with specialisation in sociology. Prior to my studies, I had tended to view health as a layperson would: as a domain of medicine. However, while taking undergraduate courses in social demography, health, sustainable development and gender, I began to see health as a social issue instead of solely a medical or clinical problem. In particular, I developed a more complex understanding of how social, cultural and economic forces shape health status, learning that age, sex, gender, class, ethnicity, geography, and “race” were important predictors of health outcomes. I also learned about inter-country and intra- country variations in health outcomes, often measured in terms of life expectancy, mortality statistics and so on. These social studies of health and medicine have fascinated me since that time.

As a developing country, Bangladesh’s population experiences a poor health status. Following rapid social and economic change, however, health status has improved significantly in recent years. Per capita income rose to $USD 1,314 in 2015, which led the World Bank to declare Bangladesh a lower-middle income country as opposed to its earlier low-income status (Bangladesh Bureau of Statistics [BBS], 2014). Until very

3 recently, the country had one of the highest infant mortality rates in the world. However, this rate dropped from 50 live births in 2005 to 35 per 1000 live births in 2011 (BBS, 2013). In parallel, maternal mortality rates also decreased, from 3.23 in 1998 to 2.09 in 2011 per 1,000 live births (BBS, 2013). Life expectancy has increased from 62.7 years in 1999 to 69 years in 2011. However, many of the infectious diseases, such as tuberculosis and malaria, now under control in the developed world, are still prevalent in the country. In Bangladesh, the discourses of medicine dominate the public psyche; little effort has been made to raise health awareness among the population and health promotion approaches have been adopted only by some non-government organisations, such as BRAC (formerly the Bangladesh Rural Advancement Committee) and Gonoshaistho Kendro (a Bangladeshi non-government organisation). Nevertheless, increases in income, rapid economic growth and decreasing poverty might have contributed to better health status.

As an educated and aware citizen in a country with high adult illiteracy rates, I have been concerned with overpopulation, high population density, and high maternal and infant mortality rates in Bangladesh. Additionally, I observed while a school student that many under-aged girls in my neighbourhood were being “married off” − often without their consent. I felt that many people were not able to make an informed choice about their reproductive and sexual lives. These questions motivated me to complete a thesis on women’s reproductive and sexual health decision-making, a topic that had caught my interest while I was doing courses in gender, and population and development at the University of Dhaka.

In reflecting on my work on women’s reproductive health, I realised that men were largely missing from the story, even though my research suggested that men tend to influence reproductive decisions in Bangladesh and that, contrary to popular explanations given by researchers (Kamal, 2000), both men and women influenced the timing and spacing of childbirth. I also came to realise (both personally and more generally) that men’s reproductive and sexual choices and decisions are shaped by dominant gender ideologies.

I have grappled with societal pressure to have children in my personal life and felt the emotional burden of being a man in patriarchal Bangladesh, where men are largely

4 expected to be the head of a family. When I took courses in gender or listened to lectures on gender and sexuality, I found that their content said little about the lived experiences of boys and men in Bangladesh as far as sexuality was concerned. Men were largely framed in particular ways − as abusive, as potential rapists, as responsible for gender violence, and/or as enemies of women.

Additionally, I realised that I had received very little information and education concerning sexuality in the conservative, predominantly Muslim country. I had known of some cases of child sexual use or abuse by older men in Bangladesh. I myself had experienced multiple instances of sexual advance towards me by older men when I was a child. Although some men may perpetrate violence and be abusive at some times, as mentioned above, all men are not violent or abusive at all times. Thus, the differences in men’s social practices call for the reconceptualisation and rethinking of men and gender.

Against this background (and despite the social taboo attached to open discussion of sex), fear of HIV, rapid population growth and high maternal mortality in Bangladesh have opened up some opportunities for engaging with sexual health. However, while sexual behaviour was mentioned in the context of HIV, especially in early 2000s, discussion rarely addressed sexuality issues more broadly. Although HIV infection in Bangladesh was and still is one of lowest in the world, epidemiologists described the rate of other sexually transmissible infections (STIs) as high (Muna, 2005), which is indicative of poor sexual health. During my studies, I discovered that little research was conducted on sexual health and men’s sexual health, in particular. In this context, and given my background, I identified men’s sexual health as a significant gap in the literature and decided to embark on this study. Moreover, given the rapid social economic, cultural and political change in Bangladesh described above, and after the commencement of my study at the University of New South Wales in Australia, I felt it perhaps advisable to apply a generational perspective to the study. My reading and reflection took me to the work of a range of theorists, whose work I will briefly discuss below and explore more fully in subsequent chapters.

Theoretical underpinnings

This thesis is informed by three interrelated bodies of knowledge: (1) the study of men and masculinities, (2) theories of social generations, and (3) critical research on sexuality and sexual health.

First, the concept of “masculinities” implies socially, historically, culturally and politically produced ways of being a man (Srivastava, 2010; Kabesh, 2013). In other words, there is no single way of being a man, or of enacting masculinity (Connell, 1995). Connell (1995) defines masculinities as “configurations of practice structured by gender relations” (p. 43), arising in the context of the dominant gender order of society. The term gender order refers to the structure of gender relations at a given time in a given society (Connell, 2012). In a patriarchal society, women are generally placed in subordinate positions and men tend to dominate the economy, legislative and judiciary structures, and the family.

Men and masculinities is today a multidisciplinary field of research, academic interest and activism. Literature on men and masculinities has proliferated since the 1970s and there is now a body of knowledge that can loosely be described as “men’s studies” (Connell, 1995, p. 24; 2005, p. xii). Since the 1970s, concerns have been expressed regarding a “crisis in masculinities” in Western countries (Horrocks, 1994), pointing to the challenges of being a man. Early authors argued that men suffer greatly from the demands of their gender roles (Harrison, 1978). Articles and books with provocative titles such as “The inexpressive male: A tragedy of American society” (Balswick & Peek, 1971) appeared in the 1970s. Numerous books, scholarly articles and men’s magazines have appeared since then. These publications have generated much debate about men, gender, masculinities, men’s gender roles, men’s poorer health outcomes, and men’s purported inability to “get in touch with their feelings” (Pease, 2000, p. 128, as cited in Haywood & Mac an Ghaill, 2003, p. 129).

Although the writing around men and masculinities in the early 1970s generated public attention and debate about gender and men, importantly, it did not produce much empirical research. Connell (1995) argues that these writings belonged to popular psychology and counselling. In the last couple of decades, however, a growing amount

6 of empirical research has appeared, mainly from Western countries, but some from non- Western countries as well (Connell, 2005, 2012). Multidisciplinary research is now paying attention to masculinity in relation to men’s association with a wide range of social problems (violence, crime, drink-driving, educational difficulties, health problems) (Connell, 1995, 2000, 2005; Connell & Messerschmidt, 2005). Of particular significance for the present study is research demonstrating how enactments of masculinities may be linked to health problems (Sabo & Gordon, 1995; Courtenay, 2000a; Connell, 2012).

Globally, much research on masculinity and health has been produced in and focused on Euro-American contexts (Jones, 2006; Osella & Osella, 2006), although more recently research on men, masculinities and health from outside this context has been published (Ikeya, 2014). Although there are some notable exceptions, to date, relatively little research has focused on South Asia, including Bangladesh. Much of the available sexual health literature focused on South Asia tends to engage with questions of gender and health more broadly, with little specific focus on masculinity and health. Moreover, as elsewhere in the world (Schofield, Connell, Walker, Wood, & Butland, 2000), gender in relation to health in South Asia is often narrowly understood as implying women’s health concerns (Hasan, Aggleton, & Persson, 2015).

Connell and Butler, two highly influential social theorists, have advanced anti- essentialist understandings of gender and masculinity. Instead of seeing masculinity and femininity as innate characteristics or behaviours learned by men and women through processes of socialisation, they argued that men and women (and others) conduct their gendered lives in complex and contradictory ways. While Connell (1995) has suggested that masculinities are multiple and changeable, Butler (1990) argued that gender is performative. A detailed account of their theorisation of gender is provided in chapter 3.

Second, since the first articulation of the concept of social generations by Mannheim (1952 [1923]) in the 1920s, it has remained a neglected concept in interpreting the social and the sexual although “human sexualities are deeply generational and need analysis and study” (Plummer, 2010, p.170). More recently, however, the sociological concept of generations has gained influence in explaining and interpreting social change

(Vincent, 2005; Foster, 2013; White, 2013; Plummer, 2010; Newman, de Wit, Reynolds, Canavan & Kidd, 2016), long after its first articulation by Mannheim (1952).

Mannheim (1952) defined social generations as social groups formed through similar historical events who share similar worldviews, thoughts and social action (p. 291). For him, “the social phenomenon of ‘generation’ represents nothing more than a particular kind of identity of location, embracing related ‘age groups’ embedded in a historical social process” (Mannheim, 1952, p. 293). While generation is usually understood in terms of age cohorts, Mannheim argued that generations tend to have similar experiences, certain characteristic modes of thought and a particular type of historically relevant behaviour (Mannheim, 1952, p. 291). Thus, Mannheim emphasised the social significance of generations, in contrast to seeing them as mere birth/age cohorts.

Changes in cultural norms and practices, including sexual practices, are often attributed to the “generation gap” (Pilcher, 1994; Muna, 2005, pp.8-9; Plummer, 2010; Twenge, Sherman, & Wells, 2015). For example, the recent surge in new HIV infections among men who have sex with men in the Asia-Pacific region has been explained in terms of the use of technology, such as hook-up apps by members of the younger generation in these countries (McClure, 2015). The shift from dating to hook-up culture in the context of American college campuses is similarly attributed to generations formed through different social and economic environments in the USA (Seidman, 2015). To date, little research in the South Asian context and internationally has focused on generational differences (and similarities) in understandings of masculinities and sexual practices. Therefore, Mannheim’s concept of social generations is used in this study to develop a better understanding of the provisionality and multiplicity of masculinity and to examine the implications of masculinity for men’s sexual health in the Bangladeshi context.

Third, this study is located within the realms of critical sexuality and sexual health research. Dowsett (2015) has characterised this field as being concerned (among other things) with the social and cultural dimensions of sexuality, sexual cultures, sexual practices, sexual and gender identities, migration and sex work. Research in this area has pointed to important cultural variations in understandings and meanings of sex and sexual practices. It has also highlighted how sex and sexuality are important constitutive

8 elements of people’s lives (Kimmel, 2007, p. xi), with sexual health being closely linked to human well-being.

Consequentially, perhaps, has been an increased emphasis on sexual health within the international public health arena. The World Health Organisation (WHO) now recognises the importance of gender inequality and masculinities, alongside other social, cultural, economic and legal factors that impact on sexuality and sexual health (WHO, 2010, pp.13-19). In its current working definition, WHO defines sexual health as follows:

a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence (WHO, 2010, p. 3).

For some time, research has suggested that men’s enactments of particular forms of masculinity have implications for men’s health in general (Courtenay, 2000a), and for their sexual health and help-seeking practices in particular (Gordon & Sabo, 1995). By bringing together insights from Connell’s theory of masculinities and Butler’s work on gender performativity, I hope to explore these issues in greater depth. Moreover, by adopting a social generational approach, I hope to advance a fuller and more adequate account of the multiplicity and possible mutability of masculinities as they have been lived in recent times in Bangladesh.

Methodological approach

Congruent with the above theoretical framework, I decided to use a qualitative approach to address the research questions posed on page 2. The theoretical framework I adopted demanded the use of an in-depth method to capture the multi-dimensional aspects of masculinity. I did this by seeking to examine men’s understandings and enactments of masculinity, their sexual practices, their health-seeking practices and the possible relationships between masculinities and sexual health.

Using a cross-sectional study design, the research was conducted in three Bangladeshi cities with men representing three social generations. The selection of participants was informed by Mannheim’s work on social generations mentioned above. For the purpose

9 of this study, the three groups of men comprised the “war generation” (pre-1971), the “post-war generation” (post-1971) and the “generation of the new millennium” (post- 2010s). Semi-structured interviews were conducted with a total of 34 men; ten men from the older social generation (pre-1971), 11 men from the middle social generation (post-1971) and 13 men from the younger social generation (post-2010s).

The war generation, or the older social generation men, had collective memories and historical experiences of the Liberation War of Bangladesh. The nine-month long war was fought between Pakistan and Bangladesh (former East Pakistan) in 1971. Men belonging to this social generation grew up in the context of the political struggles against West Pakistan (now Pakistan) following the Partition of India in 1947. They had grown up in Bangladeshi villages, but had later migrated to the cities for various reasons. They embraced the growing sentiments and cause of the Bengali nationalist movement at the time. Some took part in the Liberation War in 1971, while others had migrated to India during the War.

The post-independence generation or middle social generation men, the group to which I belong, experienced the turbulent times of military rule and transition to democracy in the 1990s. Men of this generation grew up at a time of significant social and cultural change, characterised by openness to the global market, introduction of satellite television, rapid urbanisation, higher foreign investment in the economy, growth of the garment industry and non-government organisations. They were employed in economic activities in the urban informal sector, and in the booming ready-made garments and service industries in Bangladeshi cities.

The generation of the new millennium (or younger social generation men) included mainly urban youth who are well-connected to the global village. These young men were profoundly influenced by the accelerated process of globalisation, Western lifestyles and ideas. Most used English alongside Bengali in their everyday lives and at their educational institutions, unlike the war generation who used only Bengali. Other important characteristics of this generation were a certain indifference to politics (unlike previous politically conscious generations), the desire to settle in Western countries or work for multinational corporations, and use of the latest technologies, such as mobile phones, the Internet and laptop computers. In popular media, this generation has often

10 been called the Internet or Facebook generation and even the “impatient” generation. More information about each of the generation’s socio-economic and demographic profile is provided in chapter 3 and in the empirical chapters 4 to 6.

Significance of the study

In contrast to popular understandings and much of the existing literature, this study aimed to provide more nuanced insight into the multiplicity, provisionality and variability of men’s enactments of masculinities, and the implications of masculinities for men’s sexual health across social generations. Utilising a broadly abductive research strategy (Blaikie, 2007, pp. 88-104), informed but not over-determined by existing scholarship, this study seeks to capture an emic view of men’s understandings of gender, their attitudes to sexuality, their sexual practices and their health-seeking practices.

The study is perhaps the first to apply a social generational approach to the study of masculinities, men and men’s sexual health in the Bangladeshi context and one of very few in the South Asian context. While existing research, such as that by Osella and Osella (2006) in South India and Srivastava (2004b) in New Delhi and Mumbai, has provided illustrations of masculinity in relation to class and caste, no study has as yet sought to explore understandings of how masculinities and sexual practices vary across social generations. Thus, the study contributes original insights into the ways masculinities and sexual practices differ from one social generation to another one. Moreover, it seeks to unpack how men’s health-seeking practices are influenced by men’s enactment of specific forms of social generational masculinity.

Organisation of the thesis

Chapter 2 entitled “Men, masculinities and health: literature review”, provides a review of existing literature in the area of gender, masculinity and men's health. This chapter offers a review of international literature in the field. Next, it provides a description and critique of the existing South Asian literature on masculinity and men's sexual health, highlighting recurrent patterns and limitations in the existing body of literature, as well as providing the rationale for the present research.

Chapter 3 is entitled “Mapping the research journey”. Its purpose is to provide details about the research design and methodology, the research setting, and the process and research materials of the study. This chapter begins by outlining the ontological, epistemological and theoretical assumptions that informed the research. Next, details are provided of research sites, research methods, techniques of data collection, approaches to data analysis and ethical issues arising during the fieldwork. Justifications for the methodology chosen and for other decisions taken during the fieldwork are also outlined.

Chapters 4, 5 and 6 present the main findings of the research, based on an in-depth analysis of the research material collected.

Chapter 4 entitled “Making a man: generational masculinities”, presents major findings relating to participants' perspectives and beliefs regarding masculinity. The chapter explores participants’ understandings of being a “real man”, their ideas about hegemonic masculinities and how they enacted gender in their everyday lives. This chapter examines how the construction of masculinity may vary across the different social generations focused on in this research.

Chapter 5 is entitled “Generational sexualities: patterns in men’s sexual practices”. In order to understand better the link between masculinities and sexual health, an examination of men's sexual practices as they are lived is necessary. Based on participants’ accounts, this chapter therefore describes patterns in men's sexual practices. Social generational differences and similarities in sexual practices and risk perceptions are highlighted. An analysis of dominant notions of masculinity and their implications for these sexual practices is then provided.

Chapter 6 “Men’s sexual health and help-seeking practices” focuses on men's use of sexual health information and services and their help-seeking practices. Specifically, the chapter explores men's understanding of sexual health, sources of health information, the kinds of information that men received from these sources, as well as the perceived usefulness, relevance and adequacy of the information received. Next, it seeks to examine cross-generational differences and similarities in the types of information

12 collected. The chapter then moves to present findings relating to men's health-seeking practices in relation to the health problems encountered, including sexually transmissible infections (STIs) and HIV. This chapter also explores factors shaping men's access to sexual health care services.

A concluding chapter, Chapter 7, “Rethinking gender/masculinities and sexual health: A social generational perspective”, provides an overview of the previous three chapters in relation to the major theoretical perspectives that informed the study. Then, using newly developed “assemblage” theory, it aims to take the analysis one step further, by highlighting stronger and more nuanced ways in which men, masculinity and sexual health may be understood. The chapter then identifies major opportunities for theoretical and methodological advancement in the fields of gender and sexuality in the South Asian context. Finally, it considers the implications of the research for future health policy, programmes and research, while acknowledging the limitations of the study itself.

Chapter 2: Men, masculinities and health: literature review

Introduction

In order to contextualise the present study, this chapter provides a review of relevant literature on men, masculinities and health. First, to set the scene, I examine international research from within the field of men and masculinities. Next, I look at the literature on the implications of masculinities for men’s health in general and for sexual health in particular. I then turn to examine more specifically the South Asian literature. As masculinities arise in the context of gender relations, I begin with an introduction to contemporary patterns of gender relations in South Asia, paying attention to broad changes in these relations, as well as local variations across countries within the region. Next, I discuss how structural features of South Asian society, such as class, colonisation, caste, and heteronormativity, affect the production of masculinities. The implications of different forms of masculinity for men’s physical, social and mental health problems are then examined. Finally, I draw the chapter to a close by providing a focused overview of the relatively few studies to date relating to masculinity and men’s reproductive and sexual health in South Asia.

Gender, men and masculinity

Gender is a key axis around which many aspects of social life are organised, with gender inequalities linked to access to and control over material and cultural resources, roles and responsibilities, and general life chances (Greene, Robles, & Pawlak, 2011). Addressing gender-based inequalities is therefore a global priority, as reflected in the United Nations’ Sustainable Development Goals (SDGs), agreed upon in September 2015 (United Nations, 2015). Among these goals, Goals 5 (achieving gender equality) and 8 (promoting sustainable and inclusive economic growth for all) highlight the importance of gender relations. In a similar vein, the earlier Millennium Development Goals (United Nations, 2000) included promoting gender equality and empowering women (Goal 3) and improving maternal health (Goal 5).

For at least a decade before those goals were promulgated, there had been much talk about and efforts to mainstream gender into development planning and practice. The

14 central theme of the 1995 Human Development Report, for example, was “Human Development, if not Gendered, is Endangered” (United Nations, 1995c). Moreover, since the International Conference on Population and Development (ICPD) in 1994 in Cairo (United Nations, 1995a) and the Fourth World Conference on Women held in Beijing in 1995 (United Nations, 1995b, p. 42), we have seen strong emphasis on actions to achieve greater gender equality and justice.

Since the term “gender” first entered international academic discourse in the 1970s (Oakley, 1972), when feminist advocates and researchers began to explore the gendered nature of social, political and economic life (Boserup, 1970; Dixon, 1982), there have been different ways of conceptualising gender. Initially, terms such as “men” and “women” tended to be used in a universal and somewhat uncritical manner, representing certain supposedly “essential” human qualities and traits (Hoffman, 1977; Harrison, 1978). Underpinning this perspective was sex role theory with its focus on the attitudes, behaviours and roles that supposedly characterised men and women (Pleck & Lang, 1978; Pleck & Brannon, 1978). In much of this literature and the more socially oriented perspectives that followed, the term gender was used to talk mainly about women, giving rise in the international development field to the notion of “women in development” (Collier, 1988). By the 1990s, however, recognition of the relational character of gender had brought about a major transformation in a rather different school of thought, notably that of “gender and development” (Kabeer, 1994; Mohanty, 1991), with its emphasis on the social processes that comprise gender relations and the inequalities these give rise to between women and men. This development, in turn, had consequences for how “men” themselves later came to be understood.

In contrast to the binary and essentialist understandings of men and masculinities provided by sex role theory, writers since the mid-1980s have tended to argue that the study of men and masculinities needs to be both critical and gendered (Brod, 1987; Hearn, 2013). Authors such as Schofield et al. (2000) have put forward relational theories of gender, defining it as a social practice that closely links to the body but which cannot be reduced to bodily characteristics in any simple way. The early study of men and masculinities was inspired in large part by the legacy of feminism and was seen as men’s reaction to feminist work on gender relations. Early authors expressed concerns about men’s emotional inexpressiveness (Harrison, 1978) and the oppression

15 generated by dominant stereotypes of men and manliness (Salam, 2009). In parallel, attention came to be paid to men’s gender roles and changes in gender relations in the context of global economic and cultural transformations. In addition, a growing body of literature detailed how specific forms of masculinity are linked to particular forms of violence (Hearn, 1994, Hearn et al., 2012), drinking and fighting (Canaan, 1996), crime (Messerschmidt, 1993, 2005), education (Haywood & Mac an Ghaill, 1996, 2013), health care behaviour (Gordon & Sabo, 1995; Courtenay, 2000a; Courtenay, McCreary, & Merighi, 2002; Sabo, 2005), sports involvement (Messner, 2005), and sexuality and sexual behaviours (Plummer, 2005).

In many ways, the study of men and masculinity can be considered a sub-field of gender studies and is relevant to achieving greater gender justice, peace and a better world. As dominant forms of masculinity link so closely to a wide range of social problems (violence, crime, drink-driving, education, and health), studies in these and other areas are now encouraging greater attention to masculinity. Since the mid-1990s, research contributions to the critical studies of men and masculinities in relation to different aspects of these problems have grown around the world (Connell, 2005, pp. xiv-xv). These studies, for example, have focused on masculinities in Latin America (Gutmann & Vigoya, 2005), South Asian masculinities (Srivastava, 2004a), East Asian masculinities (Taga, 2005), Muslim masculinities (Gerami, 2005), and so on.

It is important to recognise that gender norms and norms of masculinity have implications for both women and men, people of other genders, and children. Rigid definitions of what it means to be a “real man” have implications for men’s roles and responsibilities in society. Men are variably expected to be protectors, breadwinners, heterosexual, risk-takers, violent, dominant and powerful (Greene et al., 2011). According to Greig et al. (2000), “Misogyny, homophobia, racism and class/status- based discrimination are all implicated in a ‘politics of masculinity’ that is developed and deployed by men to claim power over women, and by some men to claim power over other men” (p. 6). It is vital, therefore, to understand the politics of masculinity if we are to develop programmes and interventions to promote gender equality and justice, and address the problems mentioned above.

Men, masculinity and health: international perspectives

The present study is grounded in the rapidly developing field of men and masculinities. In particular, it has its starting point in the critical study of men and masculinities described above. What this approach underscores are the ways in which class, ethnicity, race, sexual subjectivity and other factors influence the development of diverse forms of masculine subjectivity and practice. Researchers adopting such an approach have demonstrated how masculinities develop and are articulated within different spheres of social life. Their research also shows how masculinities vary according to social and cultural context and may change over time. These changes in patterns of masculinities have been an important subject of enquiry (Connell, 2005; Seidler, 2006). Early authors argued that international developments involving the relocation of industries from the North to the Global South had triggered a “crisis” in Western masculinity as a result of men’s newfound under-employment in manufacturing industries (Horrocks, 1994; Haywood & Mac an Ghaill, 2003, p. 23; Salam, 2009). Simultaneously, the expansion of trade beyond national borders, driven by technological development and supported by neoliberal economic policies, has led to the emergence of new forms of masculinity, including what Connell (2005) has called “transnational business masculinity” (p. xxiii). Work that is more recent examines how men are renegotiating different aspects of masculinity in the context of these and other contemporary social changes (Levtov, Barker, Contreras-Urbina, Heilman, & Verma, 2014).

The relationships between masculinity and health are a major theme in the international literature (Courtenay, 2000a; Broom, 2004; Connell, 1995, 2000, 2005; Sabo & Gordon, 1995; Robertson, Williams, & Oliffe, 2016). Sabo and Gordon (1995) have argued that dominant ideologies of masculinity negatively affect men’s health (p.16). Studies in Western countries suggest that men tend to adopt behaviours and beliefs that may have health-damaging effects (Saltonstall, 1993; Taylor, Stewart, & Parker, 1998; Courtenay, 2000a, 2000b, 2002, 2011; Broom, 2004; Noone & Stephens, 2008; Tannenbaum & Frank, 2011). Hegemonic masculinities have been shown to be associated with predatory sexual practices (Foreman, 1999), risk-taking, an unwillingness to seek health care (Sabo & Gordon, 1995; O’Brien et al., 2005, p. 503; Mahalik, Burns, & Sysdek, 2007), road accidents (Mast, Sieverding, Esslen, Graber, & Jäncke, 2008) and violence (Hong, 2000). Similarly, research in Latin American countries suggests that traditional

17 machismo – or the display of masculinities through drinking, having multiple sexual partners, domination over women and violence – may act as a barrier to both women’s and men’s health (Arciniega, Anderson, Tovar-Blank, & Tracey, 2008; Singleton, Schroffel, Findlay, & Winskell, 2016). In Connell’s (2000) view, taken together, these practices comprise some of the “toxic” consequences of the more hegemonic forms of masculinity (p. 66).

Research in Western contexts indicates that men are less likely than women to visit a physician for health care because doing so is incompatible with the idea of being “strong and tough” (Courtenay, 2000a; Galdas, Cheater, & Marshall, 2007; O’Brien, Hunt, & Hart, 2005, p. 503; Noone & Stephens, 2008) or being invulnerable (Mane & Aggleton, 2001). In order to protect their masculinity, men may enact behaviours to show that they are unemotional, aggressive and independent, and for some men carelessness towards their own bodies may be considered a positive trait and a sign of masculine strength (Broom, 2004, pp. 74-75). Research further suggests that men may be resistant to seeking health care even after the identification of signs and symptoms of disease (McCittie & Willock, 2006) and tend to hide their symptoms when they see a doctor (Baker, Dworkin, Tong, Banks, Shande, & Yamey, 2014). Hegemonic masculinity has also been shown to be a barrier to help-seeking for depression, substance abuse and stressful life events (Addis & Mahalik, 2003; Farrimond, 2011; Oliffe, Galdas, Han, & Kelly, 2012; de Medeiros & Rubinstein, 2016). Furthermore, research has revealed that the enactment of dominant forms of masculinity is linked to higher mortality among men (Staples, 1995, White, 2006, Courtenay, 2000a; Baker et al., 2014) and higher male suicide rates (Cleary, 2012; Courtenay, 2011, p. 4; Canetto, 2015).

As indicated above, research also points to some of the negative effects of violent forms of masculinity. While it is important not to stereotype all men, some men perpetrate violence against women, against other men and sometimes even against themselves – practices that together constitute what has been called the “triad” of men’s violence (Kaufman, 1987; Messner, 1992; Jewkes, Flood, & Lang, 2015; Hong, 2000). In research conducted in a mental health institution in Canada, for example, hospital security men were shown to achieve masculine status through the regular display of

18 dominance over mental health patients and other staff who embodied less masculine or feminine gender identities (Johnston & Kitty, 2014).

However, there are some indications that changes might be underway with respect to men’s health care-seeking behaviours. In a recent Australian study, Rosenberg (2009) notes that following men’s participation in health awareness programmes, “contemporary Australian masculinity is undergoing dynamic change, wherein men are increasingly attempting to integrate their masculinity with changed understandings of health and well-being” (p. 424). Similarly, Creighton, Oliffe, Butterwick and Saewyc (2013) suggest that masculine identities have changed significantly over time in Canada. Their research shows how some men reconfigure their relationship to dangerous and risky forms of masculinity following the death of a friend through engagement in risky sports. Similarly, drawing on international research, Barker et al. (2012) and Snipes et al. (2015), have emphasised the importance of recognising men’s expression of a variety of “caring masculinities” (Elliot, 2016), such as for their family, which may have positive health consequences both for themselves (e.g., through the better utilisation of health care services), and for others.

Of particular relevance to the present study is research examining the implications of dominant forms of masculinity for men’s sexual health. Research in a variety of contexts suggests that young men may be pressured to prove their masculinity by having sex early in life (Foreman, 1999). Globally, men are more likely to pay for sex than women (Hawkes, 1998) and engage in practices that carry the risk of sexually transmitted infections, including HIV (Foreman, 1999; Mane & Aggleton, 2001). Findings from an 18-country survey by the World Health Organisation (WHO) suggest that men are more likely than women to have multiple partners and engage in casual sex in their lifetimes (Foreman, 1999, p. 3), although the gender gap has narrowed recently. However, it is important not to overgeneralise and stereotype. Authors such as Higgins, Hoffman and Dworkin (2010) have questioned the representation of men as being uniformly reckless and predatory in their behaviours.

While international research suggests that masculinities are shaped by a variety of factors, including ethnicity and race, social class, work, economy and politics, few

19 studies have looked at differences in masculinity across generations, despite appeals for the adoption of such an approach (Plummer, 2010).

Ultimately, more studies of human sexualities should start to ask questions about which generations are speaking here and how they interconnect, and should be much clearer about how the different generations at any moment come to live and talk about their sexualities. Which generations dominate, who speaks and who does not? (Plummer, 2010, p. 170).

This is a call that I aim to respond to in this thesis through a focus on three different social generations of Bangladeshi men and the ways in which they sought to negotiate issues of masculinity and health.

Relatively little research has, however, explored the implications of global and local economic and cultural change or “Westernisation” in settings such as South Asia, which are also undergoing rapid change. Although class, ethnicity, and race have been discussed in relation to masculinity, few studies have explored how age and social generation may be implicated in the shaping of masculinity. There has been little exploration either of how global and local economic and cultural transformations affect local masculinities in the Global South. Responding to these concerns and drawing on Mannheim’s (1952) work on social generations, this thesis offers some insights into how local masculinities in Bangladesh are being reconfigured in the context of globalisation and urbanisation, in a context where certain other aspects of gender remain resistant to change.

Gender relations in South Asia1

South Asia is a remarkably diverse region in terms of language, religion, ethnicity and culture. However, certain key features are consistent across South Asian societies, including low socio-economic and human development, high levels of poverty, high maternal and child and infant mortality, pervasive systems of patriarchy, and heteronormativity. In this context, women, hijra2 and same-sex-attracted people occupy

1 Elements of this section draw partly on a published paper developed as part of this PhD (see Hasan, Aggleton, & Persson, 2015). 2 Hijras are neither men nor women and are often castrated. They dress in women’s clothes. They form a social, economic and political community across South Asia. Previously called the third gender, these people are increasingly understood as transgendered people (Boyce & Khanna, 2011, p. 98).

20 a subordinate position in relation to men (Arens & van Beurden, 1980; Majumder, 1999; Khan, 2004). With respect to women, the gender inequality index (GII) for South Asia in the year 2012 was 0.568, which indicates that the region is still far from achieving gender equality (United Nations Development Programme [UNDP], 2013, p. 31). Low participation of women in the labour force, major gender imbalances in educational participation and attainment, and the under-representation of women in politics and positions of power reflect persistent gender disparities across much of the region (UNDP, 2013, p. 31), and Bangladesh is no exception in this regard with a gender inequality index3 of 0.529 (UNDP, 2015).

The distinction between the public and the private domain is far starker in South Asia than elsewhere in the world (except perhaps in the Arab world). In many South Asian societies (and despite wide reaching social and economic change), there remains masculine anxiety regarding women entering the public sphere, especially when this is perceived as violating norms of modesty (Srivastava, 2010). Across South Asia, notions of purity and pollution associated with the female body, the practice of purdah (veil or the institutional seclusion of women from men other than close relatives), and notions of family honour hinder women’s participation in the public domain (Rozario, 1992; Wu, 2011; Sultana, 2015). Men in a South Asian context are generally thought of as the providers and protectors of their families. Indeed, the ability to provide for families constitutes one of the common features of being a man (Muna, 2005, p. 13). Men are expected to protect their wives and daughters from sexual assault (both real and imagined) by other men (Staples, 2011). Pashtun men living in Pakistan and Afghanistan, for instance, are considered to be protectors of the “three zs”: zan (women), zar (gold or property) and zamin (land) (Khan, 2006, p. 368). Any unwelcome touch or harassment of women by unrelated men is seen as a threat to masculine and family honour, and invites the severe punishment of the perpetrators and sometimes the victimised women by local men (Khan, 2006, p. 368-371).

3 The gender inequality index measures men’s and women’s achievement in three key dimensions of human development such as health, empowerment and the labour market. A measure of 1 indicates absolute equality. A measure of 0.53 (rounded) here indicates that women are lagging behind men by 47 percentage points.

As heterosexuality is constituted as the dominant ideology, the homo-erotic aspects of homosexuality tend to “arouse puzzled opprobrium” in many South Asian countries (Simpson, 2004, p. 164). As a result, same-sex-attracted men must live a “double sexual life”, hiding the explicitly sexual dimensions of their same-sex relationships from public view (Chopra, Dasgupta, & Janeja, 2000). Such is the social pressure to conform that most same-sex-attracted men in India and Bangladesh are heterosexually married to women or wish to marry a woman in the near future (Khan, 1997, 2004; Khan et al., 2006a).

While in some South Asian countries, and perhaps particularly in India, there has been an opening up of gender relations in recent decades (Verma et al., 2006) – with upper and upper middle class women and men more able to live their lives in ways more closely aligned with gender equality – traditions remain strong. In some countries there has been a backlash against what may be seen as Western practices and values. Purdah is still a common custom in countries such as Pakistan (Wu, 2011, p. 220). It is also found in Afghanistan, Bangladesh and parts of India. In Bangladesh, Hefajot-e-Islam, a new orthodox Islamist political organisation in Bangladesh, has recently put forward a 13-point set of demands to the “semi-secular” government. These include, among other things, stopping the free mixing of boys and girls and taking stern measures against the influence of foreign culture (The Daily Star, April 6, 2013). More recently, the killing of secular writers, bloggers, publishers and a magazine editor who advocated for the rights of somokami (same-sex-attracted people), together with the rise of radical political Islam, have become a major concern (Bhattacharjee, 2016).

Men, masculinity and health in South Asia

Globally, much research on men’s health has focused on Euro-American contexts. Until recently, little research has examined the implications of masculinity for health in the South Asian settings (Chopra, Osella, & Osella, 2004). Since the 2000s, however, some important studies have been undertaken (Collumbien & Hawkes, 2000; Chopra et al., 2004; Khan, Hudson-Rodd, Saggers, & Bhuiya, 2005; Srivastava, 2004a, 2004b, 2010; Osella & Osella, 2006; Boyce, 2007; Boyce & Khanna, 2011; Imtiaz, 2012; Osella, 2012). Several of these studies emphasise the legacy of culture and history, as well as more recent processes of social and economic transformation, for men’s health.

In order to provide some background to the present study, I will first discuss how masculinities in South Asian context have been shaped by these larger political and economic factors, as well as by specific forms of South Asian religion and culture. I will then look at the implications of masculinity for health within this context.

Men and masculinities in South Asia

As South Asia is an extraordinarily diverse region, there are many different ways of being a man and many different cultural forms of masculinity are constructed and enacted, with concomitant implications for men’s self-understandings and health. Colonisation, religion, caste, class and local norms interact to produce specific local South Asian masculinities. Sinha (1995), in a historical study of masculinities, describes how Bengali masculinity came to be constructed in relation to colonial English masculinity in Bengal in the late 19th century. Processes of colonisation, for instance, were associated with the emergence of particular forms of masculinity (Connell, 2000).

Sinha (1995) suggests that colonial English masculinity was defined in terms of a love of competitive sports, especially hunting, a disdain for the “bookworm”, a chivalric approach to women, and a celebration of general competence (Mackenzie, 1997, p. vii). The 19th century Bengali babus,4 in contrast, were described as “effeminate, bookish, over-serious, lustful and lacking in self-discipline” (MacKenzie, 1997, p. vii). The Sikhs and Pathans, on the other hand, were generally described by British colonial administrators as strong and war-like, in other words, as more masculine than their Bengali peers (Sinha, 1995). Winston Churchill claimed, based on his experience and research, that every Pashtun man5 was a warrior (Churchill 1898; Khan, 2006, p. 368- 371).

4The babus were Hindu Bengali men mainly from the middle class, which grew because of English education and employment in the colonial administration in the 19th century. 5 The Pashtun or Pathan (in Hindi/Urdu) is an ethnic group living in Afghanistan and in the North-western provinces of Pakistan (Khan, 2006).

As the activities of colonial rulers facilitated the development of local forms of masculinity, the colonised people in their attempt to gain independence constructed alternative responses. Nationalist leaders, for instance, sought to redefine masculinity in ways that contested the definitions offered by more colonial forms of discourse (Srivastava, 2010). Nandy (1983), for example, suggests that Gandhi enacted a “soft” but unyielding form of Hindu masculinity to foreground the oppressive and subjugating masculinity of the colonial rulers. Gandhi’s non-violent nationalist independence movement bears testimony to the effectiveness of such a soft approach.

During the British colonial period, heterosexuality was constituted as the dominant form of masculinity through legal regulation. Male-to-male sexual practices in countries, such as India, Pakistan and Bangladesh, were defined as “acts against the order of nature” by the Indian Penal Code section 377 (Khan, 2004, p. 3), which was closely mirrored on earlier UK legislation. The section was repealed in India in 2009 but enforced again in 2013 (Boyce, 2014), suggesting tensions and contradictions concerning the status of same-sex sexual relations in the conservative Indian society. Though rarely enforced, section 377 of the Penal Code has not yet been repealed by the two predominantly Muslim nations of Pakistan and Bangladesh.

Research suggests that political transformation in postcolonial South Asia has also influenced the production of different forms of masculinity. The Liberation War between Bangladesh and Pakistan, several wars between Pakistan and India over the control of disputed Jammu and Kashmir, the civil war between the Tamil rebels and the Singhalese, the Maoist rebellion in Nepal, underground leftist politics across India and Bangladesh, and national identity politics have variously shaped the production of masculinities (Bhan, 2006). Conflict and war between Pakistan and India, for example, resulted in the production of a variety of “military” forms of masculinity (Bhan, 2006, pp. 269-271), with both rival nations investing in the procurement of nuclear weapons, and in recruiting and training young men in the army. Banerjee (2006) suggests that the Hindu women of Gujarat, for instance, also enact this form of nationalist “armed” masculinity as heroic mothers, chaste wives and celibate warriors.

As is the case elsewhere, being a warrior in conflict-ridden South Asia is considered an honourable way of being a man. For instance, the Bengali freedom fighters, who fought

24 against Pakistani soldiers in 1971, currently enjoy higher social status and their children receive extra privileges from the state (e.g., quotas for government jobs). The Afghan governor of Herat province, who successfully fought against both the Soviet Union and the Taliban, takes pride in being a warrior (MacKinnon, 2006, pp. 215-217), maintaining his semi-autonomous rule in Herat through the use of private soldiers and spies (MacKinnon, 2006, pp. 215-217).

Mookherjee’s (2004) study of women raped by Pakistani soldiers during the Liberation War in 1971, a study which also included the women’s husbands, demonstrates how masculinities have been articulated in post-independence rural Bangladesh. Mookherjee (2004) suggests that jeers and taunts were used regularly by community people against men who were viewed as having “lost” their masculinity by failing to protect their wives from rape. The women also faced stigma in post-independence Bangladeshi society as rape meant a loss of izzat (honour). Mookherjee’s research further demonstrates how the husbands tried to reassert their “lost” masculinity by telling stories of their participation in the Liberation War (i.e., a sign of masculinity) by assisting Bengali freedom fighters against Pakistani soldiers.

Although these studies of colonial constructions of masculinity offer insights into an understanding of South Asian masculinities, by themselves they do not adequately provide a thorough understanding of the same issues in post-colonial contexts. This is because globalisation, modernisation and urbanisation have had a powerful influence on the region, in turn contributing to the reconfiguring of gender relations. Srivastava (2004b), among others, suggests that ethnographic research in conjunction with historical research conducted in South Asia is needed to provide a better understanding of the diversity of contemporary masculinities in modern day contexts.

Ethnographic research in Kerala, South India, indicates how religion, age, caste and class play out in complex ways in the formation of Hindu masculinity. Just as an initiated Brahmin boy becomes a man through his ability to perform puja (worship), a lower caste dalit boy needs to bring in cash and/or food, and provide subsistence to his family to demonstrate his manhood (Osella & Osella, 2006, pp. 39-44). During initiation ceremonies, Brahmin men separate from women, other men and children and practise brahmacharya (celibacy) as a way of becoming a high-status Hindu man. In

25 contrast, lower class and caste Hindu men may migrate to other Indian states and the Gulf to find work to mark their entry into manhood (Osella & Osella, 2006, p. 47-48).

Research in Tamil Nadu indicates that different forms of masculinities may be produced across different generations (Anandhi et al., 2006 [2002], pp. 387-392), and that caste, class, gender, sexuality, land ownership patterns and work shape the production of masculinities in complex ways. Whilst in the past dalit men were seen as effeminate by the upper caste mudaliers6, who used to employ them as agricultural workers, the current generation of dalit male youth defines masculinity differently. Some younger generation men, unlike their predecessors, engage in drinking in public, try to make upper caste mudalier women fall in love with and marry them, engage in body building, misuse parents’ money, and look for non-agricultural work. Their enactment of these masculine practices may be seen as a reaction against the class and caste-based exploitation of previous generations of both men and women (Anandhi et al., 2006 [2002], pp. 387-392).

Research also suggests that religion, especially Islam, plays an important part in the production of masculinities in South Asian countries, especially in Pakistan, Bangladesh, the Maldives and among Muslims in India and Sri Lanka. Studies in Lahore, Pakistan (Walle, 2006, pp. 50-51) and in Layyah, Pakistan (Chaudry & Izaz, n.d.), suggest that being a “good” Muslim is often considered a key aspect of being a man. Although being a good Muslim means, for instance, the avoidance of alcohol and sex outside marriage, some well-educated Pakistani Muslim men have been found to have extra-marital sexual relations and consume alcohol (Walle, 2006, p. 51). These men tend to enact different forms of masculinity depending on the context. While within the context of their family they may try to appear as good Muslims, in all-male friendship/professional networks they may valorise certain aspects of “modern” masculinity including having multiple girlfriends, drinking and partying (Walle, 2004, 2006).

There are different forms of Islamic traditions in South Asia; each has followers in varying numbers (Samuel, 2012; Sondy, 2014). While there have been various forms of

6 The mudaliers are a land owning upper caste in Tamil Nadu, who used to employ lower caste men and women as agricultural workers (Anandhi, Jeyaranjan, & Krishnan, 2006 [2002], pp. 387-392).

Islam such as Sufism, more politically oriented Islam represented by Jamaat-e-Islami7 also plays a significant role in politics and society in Bangladesh and in Pakistan (Sondy, 2014). The Islam that developed in Bangladesh, Pakistan and India has been described as tolerant, syncretic and Sufi-influenced (Ahmed, 2011; Samuel, 2012; Sondy, 2014). One reason for the practice of syncretic Islam in Bangladesh derives from the fact that when Islam was introduced in the Bengal region in the 13th century or earlier, a process of mutual assimilation took place with local cultures, including local religious practices followed since ancient times (Samuel, 2012). Before the arrival of Islam, people in Bengal followed animism, Hinduism, Buddhism and so on. Indeed, the Bengali term shune musalman (becoming Muslim by hearing from others) refers to the idea that most Muslims in Bangladesh are not as “real” in their faith as their Muslim counterparts in Saudi Arabia.

While Sufism emphasises purity of the soul and deep spiritual connection with Allah (God), the aim of some politically oriented Islamic parties, on the other hand, is very different, being focused on the establishment of an Islamic state governed by Shariah law, through violence and/or force. Nevertheless, research on young Bangladeshi men living in Bangladesh and in the UK suggests that many such men have little interest in the more “extremist” forms of political Islam (Rozario, 2012). A small survey conducted recently in rural Bangladesh found that 79 percent of rural Muslim men and women did not vote for the political party Jamaat-e-Islami in the 2008 elections (Ahmed, 2011). However, as mentioned earlier, the rise of radical Islam has recently become a matter of concern in Bangladesh as well across South Asia (Bhattacharjee, 2016).

Islam in Bangladesh seems to co-exist with local practices and it has, in fact, become embedded with local cultures and folk religions. Local elements of non-Islamic practices include childbirth rituals, the use of turmeric on the bodies of bride and bridegrooms during marriage ceremonies, and agricultural rituals (Rozario & Samuel, 2010). Although these local cultural practices may be considered Hindu in character, they are perhaps best understood as forms of folk religion (Samuel, 2012).

7 Jamaat-e-Islami is a major Islamist political party founded by Maulana Abul Ala Maududi in Pakistan. The main goal of its politics is to establish the sovereignty of Allah (God) and an Islamic state.

Traditionally, Muslim men are expected to be strong but gentle (Samuel, 2011) and they are often represented as patriarchal (Ahmed, 2008b). Men and women in both rural and urban Bangladesh subscribe to the view that the Prophet Muhammad offers a role model of a good Muslim man (Ahmed, 2008a). They emphasise how the Prophet was never abusive to his wives but loved them and respected them. According to Islamic teaching, the Prophet Muhammad was strong, caring, compassionate, tough, aggressive and forceful when needed (Samuel, 2011). In general, in the popular Islam of South Asia, Muslim men are expected to imitate the behaviour of the Prophet (Samuel, 2011), and Muslim women are expected to follow the lifestyles of Ayesha and/or Fatema (respectively the Prophet’s wife and daughter), who epitomise good Muslim women.

The Quran is explicit concerning male authority over women and men are supposed to be the guardians of women and children (Samuel, 2011). However, Islam (as practised in Bangladesh and/or Pakistan) often deviates from such Islamic instruction. Bangladesh and Pakistan, for instance, have had women prime ministers –something of a contradiction in South Asian politics, which is generally marked by women’s low political participation, as mentioned above. Nevertheless, a small proportion of women have also been elected as members of the parliament and in city council and local government elections. Thus, Islam as practised in South Asia differs from its counterparts in the Middle East and may even vary within the same region depending on cultural, social and economic contexts. The notion of syncretic Islam may partly explain these seemingly contradictory processes (Ahmed, 2011).

Based on ethnographic research in rural Bangladesh, Ahmed (2011) has argued that ijtihad8 or boodhi (wisdom) is central to the moral imagination of Muslim women in rural Bangladesh. Her study suggests that women use boodhi as a tool by which to gain agency in an otherwise strongly patriarchal society (Ahmed, 2008a, 2008b, 2011). By employing such an approach, women have been able to question some of the religious restrictions imposed on their mobility and working outside the home, arguing, for instance, that the Quran and the hadith (teachings of the Prophet Muhammad) do not prohibit women from going outside the home or working. Ahmed (2011) observes: “In rural Bangladesh this heterodox tradition of ijtihad is fueled by the heritage of syncretic

8 The Arabic word ijtihad implies the independent interpretation of religious texts such as the Quran or Sharia (Islamic laws) by applying logic.

Islam that combines the bhakti (devotion) and Sufi traditions, both of which emphasize loving service to God” (p. 128).

In the wake of modernist Islamic movements, such as Tabligh Jamat, a non-violent and non-aggressive form of Muslim masculinity has also emerged in South Asian countries (Samuel, 2011). Adherents of Tabligh Jamat are often described as feminised Muslim men as they learn how to cook and share food with others, while on chilla (religious missionary tours) (Metcalf, 2000). Tabligh Jamat men who adhere to Sufi notions of inner struggle, purification of the mind/soul, and self-abnegation in relation to the Divine tend to downplay the aggressive and/or violent aspects of masculinity (Samuel, 2011).

Although much previous research, especially in the context of South Asian men in the UK, has tended to represent South Asian Muslim men as violent (Samuel, 2011), Hopkins’s (2006) more nuanced research points to the complex processes of negotiation implicit in the construction of Muslim masculinities and the renegotiation of identities. Research in Pakistan suggests that young Muslim men may enact multiple masculinities that do not conform to simplistic and stereotypical representation of Muslim men as either patriarchal or effeminised (Sondy, 2014). Similarly, in Bangladesh, a range of Muslim masculinities can be found. Men sometimes assimilate Western values alongside Islamic or traditional Bengali values, while at other times they may dismiss Bangladeshi and Western values in favour of a more pro-Islamic lifestyle (Samuel, 2011.

Taken together, the studies cited above suggests that the processes of becoming a Muslim man and enacting Muslim masculinity are both contradictory and complex, being influenced by a variety of factors including local culture, ethnicity, modernisation, migration and different versions of Islam.

Masculinities and health in South Asia

Relatively few studies have focused on masculinity and health in South Asian contexts. Much of the available literature in South Asia seems to engage with questions of gender and health rather than masculinity and health. Moreover, until relatively recently,

29 gender in the health literature has tended to be narrowly understood through a focus on women’s health concerns (Hasan, Aggleton, & Persson, 2015). Among the issues explored, research on gender and health has looked at the influences of gender on health care utilisation (Ahmed, Adams, Chowdhury, & Bhuiya, 2000), sex-selective abortions in India (Arnold, Kishor, & Roy, 2002), and the neglect of female children (South, Trent, & Bose, 2012). Also of special interest has been the unusual life expectancy rates which have tended to favour men in several South Asian countries (Fikree & Pasha, 2004).

While in other parts of the world, women tend to outlive men by a margin of about five to six years, in South Asia until recently men outlived women (Fikree & Pasha, 2004). In the last few years, however, this life expectancy trend has been reversed. For instance, in 2014 the life expectancy for men in South Asia was 66 years, while the corresponding figure for women was 70 years (Statista, 2016). The gap is widest in Sri Lanka, the country which fares best on social indicators such as education and income (Fikree & Pasha, 2004), suggesting that men’s material advantages do not necessarily translate into better health outcomes. As is partly the case also in the West, the high degree of gender inequality but lower male life expectancy in South Asia is paradoxical, particularly when considering health-seeking patterns in that region.

In contrast to the findings of international research, which tends to show that gender norms hinder men’s health-seeking, research in South Asia reveals that women encounter gender-specific barriers to seeking health care. A study in Matlab, Bangladesh indicates that women seek health care significantly less frequently than men (Ahmed et al., 2000). Based on a study in rural Karnataka in India, Sen and Iyer (2012) report that rates of non-treatment for illness are far worse for women than for men. A multi-site study in Bangladesh, India and Malawi (Gosoniu et al., 2008), as well as research in Nepal (Yamasaki-Nakagawa et al., 2001), demonstrated that women delayed seeking diagnosis for symptoms of tuberculosis for a longer period than did men. Sen and Iyer (2012) suggest that women in non-poor households in Karnataka have higher rates of non-treatment for illnesses, compared with women with their own income in poorer households, and poorer men. Studies such as these attribute women’s delays in seeking health care or non-treatment to gender roles, with men being often represented as barriers to women’s health (Mumtaz & Salway; 2005; Hou & Ma, 2012; Story &

Burgard, 2012). This particular positioning of men, together with a general lack of focus on men’s health itself, underscores the need to further study men’s gendered health- seeking practices, using insights from critical men’s studies and work by social theorists such as Connell and Butler.

Little South Asian research to date has paid attention to men’s work and its link to masculinity and health risks. Research in Western contexts has shown that paid work outside the home is central to understandings of masculinity and that certain groups of men may be at higher risk of occupational hazards, work-related stress and mental health problems. However, with one or two exceptions, this aspect of masculinity and health has rarely been studied in a South Asian context. Jackson (1999) has suggested that work intensity may account for some South Asian men’s poorer physical health and well-being, citing Kynch & MacGuire’s 1994 study, which found that agricultural wage labourers and landless workers in India were among the most nutritionally challenged and vulnerable to premature death, compared to other men and women in general. In addition, and as Umar (2015) has documented, over the last two decades in India, about 300,000 male farmers have committed suicide by poisoning themselves with pesticides or by hanging, because of their inability to repay loans.

Sex-selective labour migration from South Asia to the Middle East and East Asia may have implications for gendered health impacts. Dominant breadwinner ideologies and gender inequality mean that poorer South Asian men are more likely to cross international borders in search of work. Most of these migrant men are semi-skilled, unskilled and work on temporary work visas in dangerous environments. While South Asian migrant women may encounter gender violence and sexual harassment (Shamim, 2006), many migrant men, employed in risky occupations such as construction, die due to workplace accidents. A study of Bangladeshi workers in the United Arab Emirates (UAE), for instance, showed that work conditions for workers in the informal sector, in agriculture, construction, and the garments industries were both dangerous and precarious (Afsar, Yunus & Islam, 2002, p. 3).

Some research has looked at the health-seeking behaviour of diasporic South Asian men living in England (Galdas, Cheater, & Marshall, 2007) and in Canada (Oliffe, et al., 2010). A comparative study of South Asian men living in England and white men of

UK ancestry indicates that both groups of men tended to be late to seek health care after feeling chest pain. However, South Asian men sought care sooner than their white counterparts (Galdas et al., 2007). While fear of being seen as weak accounted for the delay in white men’s seeking of medical care, in contrast Pakistani and Indian men saw responsibility for family members and their own health as valued manly characteristics, prompting them to seek health services earlier than their white UK counterparts (Galdas et al., 2007).

Masculinities and sexual health in South Asia

After the International Conference on Population and Development (ICPD) in 1994, a growing body of research has focused on women’s sexual and reproductive health (Akhter, 1995, 1996: Hawkes, 1998; Population Council & NIPORT, 2004: Cockcroft, Pearson, Hamel, & Andersson, 2011; Char, 2011). Given high mortality rates in most South Asian countries, much of the focus of this research has been on maternal mortality, safe motherhood, family planning and child nutrition. In this body of literature, men rarely appear, but when they do so, again they are most usually portrayed as obstacles to contraceptive use and women’s reproductive health (Figueroa, Perea, & Rojas, 1998, as cited in Collumbien & Hawkes, 2000). In such a vein, Kamal (2000) has suggested that husbands’ disapproval of family planning is a major deterrent to women’s use of contraceptive in Bangladesh. Hou and Ma (2012) similarly indicate that in Pakistan men’s decision-making power negatively affects women’s ability to seek reproductive health care.

Research has also drawn attention to major sexual inequalities between men and women, and women’s limited access to sexual health information. In a classic ethnographic study conducted in rural Bangladesh, men were found to be dominant in many if not all aspects of sexual relations (Arens & van Beurden, 1980). More recently, Imtiaz (2012) has suggested that men in Dhaka, Bangladesh, tend to care largely about only their own sexual pleasure and adopt strategies (e.g., avoidance of condom use) to maximise this during sex with women. Elsewhere in South Asia, research in Kerala (Osella & Osella, 2006) and in Mumbai (Abraham, 2004) suggests that boys and male college students have greater access to sexually explicit information and materials than

32 girls, and Majumder (1999) suggests that men enjoy greater sexual freedom than women do and have greater negotiating power in the arena of sexuality in Bangladesh.

Sexual minorities and women face gender-based violence in patriarchal South Asian societies. In Bangladesh, for example, men may perpetrate violence against their wives to validate their hyper-masculine forms of hegemonic masculinity (Anwary, 2015). Similarly, same-sex-attracted kothis9, sometimes seen as less-than-men or non-men, face widespread violence, harassment and discrimination. More masculine panthis,10 on the other hand, enjoy the status of a “normal man” and they do not tend to face stigma and discrimination to the extent kothis do (Khan, 2004). Within this context, Khan (2004) has argued that stigma and discrimination are less closely linked to sexual orientation and desire than to some men’s inability to conform to dominant notions of manhood. He writes:

It is effeminacy and not the factual knowledge of male-to-male sexual behaviour that leads to harassment and violence. Harassment and sexual violence results [sic] from the fact that many kothis do not live up to the expected normative standards of masculine behaviour (p. 3).

A small but growing body of research suggests that certain groups of men (for example, truckers) have specific sexual health concerns (Rashid et al, n.d.; Majumder, 1999; Khan et al., 2006b). Collumbien and Hawkes (2000), who claim to have conducted one of the largest studies into male sexual health in South Asia, documented widespread concerns over ejaculation, penis size, erection problems, sexually transmitted diseases, impotence, night pollution (nocturnal emissions) and related physiological and psychosexual problems. In particular, the social and cultural construction of semen as a source of masculinity throughout South Asia means that its “loss” carries implications for a sense of sexual well-being. The culture-bound syndrome of semen-loss as a major non-STI-related sexual health concern of many South Asian men is now well- documented (Osella & Osella, 2006, p. 4; Collumbien & Hawkes, 2000). Based on a study in Matlab in rural Bangladesh, Khan et al. (2006b) note that men’s belief that

9 Kothis are often feminised same-sex-attracted men (Khan, 2004). 10 Panthis (or “real men”) or giryas are the more masculine men who sometimes have sex with kothis as well as with women (Khan, 2004). They are usually the penetrating partner during sex, which is why they are understood as more masculine.

33 semen does not contain “germs” has important implications for men and their partners’ sexual health and well-being, which increase the risk of STI infection for men themselves and for their sexual partners.

This body of research, mentioned above, further indicates that men’s reproductive and sexual health issues are far from adequately addressed by the existing health systems. Collumbien and Hawkes (2000) describe how men in India and Bangladesh often seek help from the unregulated private sector because reproductive and sexual services are rarely available for them through the formal health system. Likewise, Rashid et al. (n.d.), in a survey in Bangladesh, demonstrate that men, in the absence of the availability of adequate health services, often seek health services from informal health care providers.

A rather different body of literature, with a focus on “risk groups”, describes how particular groups of men may engage in risky activities that may be damaging to their sexual health (Khan, 1997; Majumder, 1999; Khan, 2003; Muna, 2005; Alam, 2010, Imtiaz, 2012). Rao, Nag, Mishra and Dey (1994), for example, studied 100 truck drivers who travelled long distance across Indian states. Truckers were reported to have unprotected sex with female sex workers, their wives and with other men, including their younger male helpers or khalasis (Rao et al., 1994). Research indicates that these groups may engage in sexual behaviours that may put them at risk of HIV infection (Alam, 2010; Muna, 2005; Imtiaz, 2012) and that a high proportion of non-marital sexual contacts are unprotected because of the non-use of condoms (Alam, 2010). Khan’s (1997) study of male-to-male sexual relations in Dhaka, Bangladesh, also found that a high proportion of male-to-male sex was unprotected and that knowledge of HIV transmission and safe sex was typically poor. Moreover, as many same-sex-attracted men are heterosexually married and have sex with women in order to enact an authentic masculinity and to avoid stigma, their unprotected sexual practices pose a risk to both themselves and their sexual partners.

A risk group paradigm largely informs HIV prevention and sexual health promotion in South Asian countries. Much of the existing research is problem-focused and tends to offer a stereotypical image of men as reckless and adventurous in their sexual endeavours. In this way, men are positioned as responsible for driving the HIV

34 epidemic and women, with few exceptions, are viewed as passive victims. In this and related literature, little attention is paid to men as gendered subjects who enact masculinities in complex and variable ways in the arena of sexuality and reproduction. Authors have failed to examine how dominant forms of masculinity may be enacted by force of heteronormative expectations, as well as disrupted, challenged and reconfigured by secular change and social and contextual pressures. Likewise, little attention has been paid to the structural and cultural production of risk practices through processes such as economic development, mobility and migration (Hasan et al., 2015).

The narrow focus to date on threats to women’s reproductive health, semen-loss, sex between men, and HIV in the South Asian literature calls for a broader approach that sees sexuality as a social, cultural, physical, mental, political and affect-laden phenomenon. Srivastava’s (2004a) edited volume on South Asian sexualities and masculinities provides one attempt to go beyond what he calls “the semen-loss paradigm”, to encompass a wider range of issues including modernisation, urbanisation, masculinities, sexual cultures, sexuality in South Asian cinema and emerging gay/lesbian identities. However, the chapters it contains focus mainly on India and Nepal. There is little mention of other South Asian countries such as Sri Lanka, the Maldives and Bangladesh – an absence, with respect to Bangladesh at least, which the present study will engage with and address.

Concluding remarks

Throughout this chapter, I have tried to demonstrate how masculinities arise in the context of the wider structural organisation of society. Social, cultural, historical, economic, geographical and political forces influence the production and reproduction of different forms of masculinity. Moreover, constructions of masculinity are being reworked and reconfigured in the wake of globalisation, rapid economic change, the relocation of industries, capital flows and deindustrialisation, among other factors. As a result, ideologies and enactments of masculinity are constantly being negotiated within these structural conditions and the opportunities and constraints they provide. Particular enactments of masculinity in different contexts have implications for both women’s and men’s physical, mental, social and sexual health. Links between masculinity and dangerous work outside the home, emotional inexpressiveness, sexual

35 dominance, and being tough and invulnerable, in particular, put some men at greater risks of health problems in general and sexual health problems in particular. Subsequent to experiencing health issues and problems, men may be reluctant to seek help from formal health services that fail to engage with their interests and needs, often preferring to use informal sector providers instead.

From small beginnings, therefore, the literature on South Asian masculinities has grown since the beginning of the twenty-first century. Studies have begun to explore masculinity in relation to diverse issues such as colonisation, religion, caste, class and politics. Relatively little research to date has, however, focused on the implications of the enactment of masculinities for men’s health in general, and their reproductive/sexual health in particular. Typically, with respect to these and related issues, men are either absent from research or are constituted as some kind of “problem”. Moreover, in the few studies that do exist, men are portrayed in a somewhat stereotypical and static manner – as violent, unthinking and dominant – which fails to take into account the complexity and changing nature of masculinity as it is lived and enacted in different situations.

Against this backdrop, the present study hopes to bridge the gap by broadening the understanding of masculinity and sexual health in Bangladesh. In order to achieve this goal, and in recognition of the cultural and historical “locatedness” of different types of masculinity, the focus will be on three different social generations of men, examining how masculinities are defined and enacted, and how sexual health is affected. In pursuit of such a goal, the study will apply a wide-ranging definition of sexual health to encompass sexual practices, knowledge about risks, aspects of pleasure, and help and health-seeking practices. This approach, I believe, will pave the way to a better understanding of the relationship between sexual health and masculinity – in Bangladesh at least – from a more nuanced and socially located perspective.

Chapter 3: Mapping the research journey

Introduction

The aim of this study was to provide a better understanding of enactments of masculinities and their implications for men’s sexual health in Bangladesh. To achieve this aim, the study sought to examine sexual practices, constructions of masculinity and help-seeking practices across three contrasting social generations of men. A cross- sectional qualitative method was employed to elicit men’s accounts on these and related matters from three purposively selected cities in Bangladesh.

The critical study of men and masculinities (CSMM) and advances in social theory, gender theory in particular, offer opportunities to approach masculinities and men’s health from new theoretical and analytical perspectives. CSMM is a field of work, which has to date remained an uncharted territory in Bangladesh, where gender has traditionally been viewed as a women’s issue. Grounded in Connell’s theory of masculinities, Butler’s theory of gender and Mannheim’s work on social generations, this thesis applied anti-essentialist theories of gendered relations to masculinities and men’s health in the Bangladeshi context. In particular, the study used a semi-structured interview method to collect men’s narratives about masculinity, sexual practices and sexual health.

The research aimed to examine three key questions: first, how, historically and culturally, specific masculinities are constructed and enacted by different social generations of men in Bangladesh; second, what are some of the significant patterns of men’s sexual practices and behaviours across different social generations; and finally, how does the enactment of different forms of masculinity influence and affect men’s sexual health?

This chapter maps the methodological journey undertaken while carrying out the research. It begins by describing some of the ontological and epistemological assumptions and the theoretical foundations that underpinned the research. As sexuality is viewed as a sensitive research topic in the predominantly Muslim conservative

37 country, the chapter discusses both everyday challenges encountered during the fieldwork and methodological issues as well as techniques of collecting men’s narratives. The chapter then discusses a number of ethical considerations, before closing with a note on reflexivity.

Philosophical foundations: ontology, epistemology and research strategy

Epistemological and ontological premises influence how researchers see the world and conduct their research (Denzin & Lincoln, 2011, p.13). Ideally, there should be consistency between the ontological and epistemological underpinnings of a study, its theoretical orientation, the research approach adopted and even data collection (Denzin & Lincoln, 2011, p.13, Savin-Baden & Major, 2013). For example, while positivist researchers, working from a realist ontology, tend to utilise quantitative methods and collect quantifiable data, interpretivist researchers more likely apply qualitative methods and produce data in the form of analytic texts. In the following sub-sections, I discuss my ontological and epistemological stance, my theoretical position, and the research approaches and strategies adopted.

Ontological assumptions

Neuman (2011) argues that research rests upon ideas concerning the nature of reality or what exists as knowledge (p. 92). These ideas, taken together, comprise an ontology. In other words, ontology refers to a theory of existence. Any enquiry into the world – whether this be a social world or the natural world – is based on some set of ontological assumptions or claims (Blaikie, 2007, p. 19).

In the social sciences, researchers make assumptions about the nature of the social reality that is to be investigated (Blaikie, 2007, p.12; Bryman, 2012, p. 32). They may make assumptions about what the social world looks like, what units it is made up of, and what connections exist between ideas about the social world (Blaikie, 2007, p. 3). Blaikie (2007) discusses six types of ontological assumptions. These are the shallow realist, cautious realist, depth realist, conceptual realist, subtle realist and idealist positions. Realists believe that there is an objective reality “out there” to be discovered (Neuman, 2011, p. 92). Social philosophers, such as John Stuart Mill, Muhammad Ibn

Khaldun and Auguste Comte, embraced such a position and through their work laid the foundations of the empirical social sciences (Blaikie, 2007).

Shallow realists believe in an independent external reality that can be apprehended through the senses, while cautious realists more readily acknowledge the “imperfections” of the human senses, but share the view that there is an objective reality independent of human consciousness (Blaikie, 2007, p.15). Depth realists believe in the existence of the external world, but argue that this reality exists whether or not it is observable through human senses (Blaikie, 2007, p. 15). Historically, ethnographic research has largely been informed by a subtle realist ontology, which recognises that “all knowledge is based on assumptions and purposes and is a human construction” (Hammersley, 1992, p. 52). More recently, however, there has been a shift towards a more constructivist paradigm within the social sciences, such as sociology and anthropology. Subtle realists share elements of both depth and cautious realist ontologies (Blaikie, 2007, p. 17). Finally, conceptual realists, like their shallow realist counterparts, believe in the existence of external reality, but argue that external reality can be known only by applying the human capacity of reasoning and rational thinking (Blaikie, 2007, p. 15).

In contrast to the realist ontological positions mentioned above, idealist philosophical accounts of the social world are sceptical of the notion that reality exists beyond the human mind; reality exists only insofar as the human mind thinks it exists. Human beings make or construct reality (Blaikie, 2007, p. 16). Idealists, and the constructivist epistemologies that flow from this position, suggest that there is no objective reality independent of the consciousness and perceptions of the individual observer or researcher (Neuman, 2011, p. 92).

My ontological position aligns well with that of the idealists. For the purpose of this study, I am interested in the socially and culturally constructed nature of reality. In my view, what we know as reality perhaps does not exist independently of human consciousness. I believe that the social world is constructed by social actors through their interaction with each other and that researchers are always part of the reality they investigate (Berg, 2009, p. 198). Ontologically, I also believe knowledge is socially situated and that the researcher and the researched actively co-produce the reality under

39 study. Similarly, key issues and concepts discussed in this thesis such as masculinities, sexual health and generations do not reside objectively “out there” beyond the researcher and the researched, to be discovered and measured. As Petersen (2003) has argued: The notion of masculinity as a composite of distinct qualities or attributes or a single definable essence is a myth that is perpetuated by scholars through their research and writing, particularly in their failure to acknowledge the history of, and particular significations attached to, the term masculinity (p. 58).

Similarly, Connell (1995) has argued that masculinities are indeed constructed socially, culturally and discursively. I am therefore interested in the socially constructed and contextually located nature of this reality.

Epistemological assumptions

In addition to ontological assumptions, research practices are informed by epistemological premises (Denzin & Lincoln, 2011, p.13; Neuman, 2011, p. 93). Epistemology concerns the relationship between the enquirer and the known (Denzin & Lincoln, 2011, p.12). It focuses on “the question of what is (or should be) regarded as acceptable knowledge in a discipline” (Bryman, 2012, p. 27). For social scientists in particular, some of the key epistemological questions are: how can social reality be known; what kinds of knowledge are possible, valid and legitimate? (Crotty, 1998, p.8). Epistemology is thus concerned with “providing a philosophical grounding for deciding what kinds of knowledge are possible” and ensuring “that they are both adequate and legitimate” (Maynard, 1994, as cited in Crotty, 1998, p.8). While ontology offers us a theory of existence, epistemology provides “a theory of knowledge, a theory or science of the method or grounds for knowledge” (Blaikie, 2007, p.18).

There are several prominent epistemological positions used by researchers. Denzin and Lincoln (2011) distinguish between positivist and subjectivist epistemological positions. Positivists believe that there is an objective reality “out there” to be discovered through empirical observation. By contrast, subjectivists do not believe that reality is independent of human consciousness. Blaikie (2007) identifies six influential epistemological positions within the social sciences: empiricism, rationalism, constructionist, falsificationism, neo-realism and conventionalism (p.19). Rationalism

40 and empiricism emphasise that through the application of reason and experience it is possible to derive alternatives to the religious ways of knowing the world prominent in 17th and 18th centuries in Europe. Rationalists believe that reality is made up of ideas and therefore the only way to know about the real world is through the direct examination of thought or the structure of mind that is shared by all humans. Rationalists tend to apply logic and mathematics, whereas empiricists use observation and experiment (Blaikie, 2007, pp.18-21). Neo-realists postulate that patterns or regularities exist in an external, observable, and independent “real” world. In this sense, this epistemological position incorporates elements of both rationalism and empiricism. Additionally, neo-realists insist that one needs to “locate the structures or mechanisms that have produced the pattern or relationship” (Blaikie, 2007, p. 22).

By contrast, constructionists believe that reality and meanings are actively created by social actors. Meanings do not naturally reside in “things” out there waiting to be discovered (Blaikie, 2007, p.19). Falsificationism, which draws on Popper’s (1961) ideas, embraces the epistemological position that a theory can never be proved, but can only be rendered false (Blaikie, 2007, p. 21). Conventionalists claim that what is known as truth is usually the outcome of consensus reached by a scientific community at a particular time in history (Blaikie, 2007, pp. 23-24).

Over the years, realist and positivist approaches have underpinned much of the research conducted on masculinities. Social psychologists, for example, have developed and used different scales and indices to measure masculinity (Thompson, Pleck, & Ferrera, 1992; Mahalik et al., 2003). One of the commonly used masculinity measurement scales is the Conformity of Masculinity Norms Inventory (CMNI) (Mahalik et al. 2003; Mahalik, Burns, & Syzdek, 2007; Tager, Good, & Morrison, 2006), a four-point Likert scale which calculates a composite score indicating an individual’s level of conformity to traditional masculine norms. Similarly, Pleck, Sonenstein, and Ku (1993) used masculinity and femininity scales to measure aspects of traditional masculine norms which they thought elevate men’s risks of homicide, use of violence and street drugs, and suspension from school and so on. In the same vein, Tager et al. (2006) used the CMNI to measure “endorsements of traditional masculine norms” to demonstrate their relationship to men’s body image. Mahalik et al. (2007) used the CMNI scale to measure men’s score on this scale and concluded that gender role socialisation and

41 greater conformity to traditional masculine norms were linked to men’s risky health behaviours (e.g., alcohol abuse and tobacco use).

In contrast to the positivist research cited above, given my alignment with idealist ontologies, this research is informed by a subjectivist, social constructionist epistemological paradigm. Epistemologically, I believe, in contrast to realists, what we know as social reality cannot easily be studied by applying methods of natural sciences because there are differences in the nature of socially constructed reality studied by these branches of knowledge. The subject matter of the social sciences does not exist in the external world to be accurately measured. The nature of social reality is actively co- constructed by researchers and the researched through interactions within a particular social context.

Methodology: research strategy

Apart from being clear about ontological and epistemological assumptions, researchers need to make choices about the research methodologies or overarching strategies that are best suited to the nature of their enquiry. Two strategies familiar to most researchers and discussed in many research textbooks are inductive and deductive logic. Blaikie (2007), however, identifies two less familiar research approaches, retroductive and abductive research, in addition to induction and deduction (Blaikie, 2007, p. 3).

In line with my social constructionist epistemological position and idealist ontology, I utilised a broadly abductive approach because, informed by the social theory outlined below, I aimed to examine the men’s narratives so as to shed light on the social meanings they attribute to themselves, their actions, their relationships with others, and their social practices. Abductive logic aims to derive innovative explanations based on social actors’ own understandings and the concepts that they draw on in their everyday lives (Blaikie, 2007, pp. 82-89). Informed by, but not dependent on pre-existing theory, the aim of abductive research is to seek out everyday concepts, meanings, and motives (Blaikie, 2007, p. 8). As an interpretivist researcher, I am interested in developing original insights into Bangladeshi men’s understandings of masculinity, their understandings of sexual health and sexual practices, as well as the culturally informed meanings they give to these.

Theoretical underpinnings

Given my alignment with a constructivist position, I approached this study through the lens of the structuralist-constructivist social theory. In line with the ontological, epistemological and methodological premises described above, this study was informed by, and grounded within three different bodies of social research. The first two of these are Connell’s (1995) theory of multiple masculinities and Butler’s (1990) theory of gender performativity. I also draw upon Mannheim’s theory of social generations to explore how masculinities may differ and/or be similar across contrasting social generations of men in Bangladesh. Together, I believe that these three theoretical models will allow me to understand how enactments of masculinities are structurally shaped but also mutable depending on the social context.

Connell’s theory of masculinities

In her influential book Masculinities (1995), the Australian sociologist Raewyn Connell expounds a theory of masculinities, developed largely out of her research and analysis in the areas of education, gender and politics in Australia (Wedgwood, 2009). Connell’s theory of masculinities has informed research in a wide range of disciplines, including education, law, geography, art, criminology and, of course, gender and masculinity studies (Connell & Messerschmidt, 2005). Research on topics as diverse as crime, health and illness, organisations, sports, education and violence in particular has sought to give concrete application to Connell’s concept of hegemonic and other forms of masculinity (Connell & Messerschmidt, 2005).

Connell advanced a structuralist-interactionist theory of masculinities, locating the construction of masculinities in wider social structures while recognising the role of individuals’ agency in shaping these same structures. The term “structure” here refers to the large-scale patterning that can be found across institutions and sites such as families, companies, governments, communities and neighbourhoods (Connell, 2012). The gendered division of labour at home and in society, the contrast between masculinity and femininity, the organisation of sexual desire along heterosexual/homosexual lines offer some examples of structural patterns in society (Connell, 2012).

Connell’s theory of masculinities developed in response to and as a critique of some of the popular psychology that emerged in the wake of the men’s liberation movement (Horrocks, 1994), as well as the perceived inadequacies of Parsonian sex role theory (Connell, 1995, p. 25). Connell maintains that masculinities are not inherited traits or tendencies, as conceived of in psychoanalytic terms. For instance, drink driving and car crashes involving men are not driven by hormones or by an uncontrollable male sex role; these masculine behaviours are linked to the enactment of masculine ideals (Connell, 2000, p. 185).

Masculinities arise in the context of social relations characterised by unequal power between men and women (also between different groups of men/women) (Connell, 2000, 2005, 1995). As Connell (2005) eloquently puts it: “Masculinities are configurations of practice structured by gender relations. They are inherently historical; and their making and remaking is a political process affecting the balance of interests in society and the directions of social change” (pp. 43-44). Connell’s research describes some of the multiple sites of social organisations (e.g., competitive sports, corporations, and the family) in which masculinities are constructed through complex and contradictory processes.

Connell’s (1995, 2000, 2005) work suggests a model of multiple masculinities and she distinguished several types of masculinity. These include hegemonic masculinities, subordinated masculinities, marginalised masculinities, complicit masculinities, protest masculinities, among others (Connell, 2000, p. 30-31). Masculinities are historically contingent and in this respect, Connell offers a dynamic analysis of historically specific masculinities (Wedgwood, 2009). Importantly, she notes that masculinities can be inhabited by men as well as women. As she explains, “[i]t is … perfectly logical to talk about masculine women or masculinity in women’s lives, as well as masculinity in men’s lives” (Connell, 2000, p. 29). Since the original articulation of Connell’s theory, a number of ethnographic studies have provided examples of multiple masculinities in different contexts. Research by Halberstam (1998), for instance, has demonstrated how masculinities can be enacted by people with female bodies.

Connell developed the concept of hegemonic masculinity in the mid-1980s (Connell & Messerschmidt, 2005), a decade before she presented a synthesis of her work in 1995.

Drawing upon the Gramscian concept of hegemony, Connell (2000) argues that hegemonic masculinity is the “culturally idealized form of masculine character” (p. 69). Bringing home a wage, sustaining sexual relationships, and being a father offer some important examples of hegemonic masculinities (Connell & Messerschmidt, 2005). Similarly, being dominant and powerful, displaying physical strength and sexual prowess, and assuming a leadership role (either through persuasion or brute force), provide examples of hegemonic masculinity in operation. Thus, some masculinities are produced as a superior and dominant gender position and in opposition to femininities (Srivastava, 2010).

In summary, Connell’s theory offers an important theoretical framework for the study of masculinities. In particular, it points to structural and historical contexts in which masculinities are constructed. However, the theory has been criticised for its somewhat static typologising of masculinity (Hearn, 2004). By virtue of their nature, typologies may limit understanding of social phenomena by suggesting that the components within them are relatively uniform or fixed.

Butler’s theory of gender performativity

Butler’s theory of gender performativity is key to understanding how masculinities are constituted through everyday social action. Butler, a prominent post-structuralist gender theorist, rejected essentialist explanations of a pre-existing gender identity. Her critique of binary notions of sex/gender and sexuality posed a major challenge to feminist political activism and political philosophy. In her major work, Gender Trouble, Butler (1990) provides a critique of conventional feminist political philosophy, which assumes that there is a subject, a pre-existing identity such as woman, for whom political representation is pursued (pp. 1-6). She argues that gender identities are not pre-given; neither are they fixed. In other words, Butler suggests that the gender categories – male/female, men/women – are brought into being performatively. That is, she argues, it is through their performative actions that individuals are understood to be masculine or feminine (Butler, 1990).

The concept of performativity is central to understanding Butler’s (1988, 1990) theory of gender. “Performativity concerns the ways that identities are constructed iteratively

45 through complex citation processes” (Weber, 1998, p. 79). Butler’s influential writing argues that gender is performative in the sense that these iterations of cultural gender norms produce gendered identities (Butler, 1993, 1990, 1988). Butler (1988) powerfully demonstrates that the gendered self does not exist prior to its enactments, which constitute the imagined and illusionary identity of the actors. “In opposition to theatrical or phenomenological models which take gendered self to be prior to its acts”, she sees gender as “a performative accomplishment compelled by social sanction and taboo” (Butler, 1988, p. 520).

Butler draws an important distinction between performance and performativity. While performance refers to deliberate acts, performativity is understood as “the reiterative and citational practice by which discourse produces the effects that it names” (Weber, 1998, p. 81). In other words, while the term performance refers to enactment or doing, performativity implies the regulation of human actions through rules, law, conventions, customs and their effects (Brickell, 2005, p. 28). While performance is an act, performativity “consists in the reiteration of norms which precede, constrain and exceed the performer” (Butler, 1993, p. 24). For Butler (1993), gender is performative in that “it is the effect of a regulatory regime of gender differences in which genders are divided and hierarchized under constraint” (p. 21, original emphasis). Butler (1993) further added that “social constraints, taboos, prohibitions, threats of punishment operate in the ritualized repetition of norms, and the repetition constitutes the temporalized scene of gender construction and destabilization” (p. 21).

A common thread in the writings of both Connell and Butler is that gender is socially, historically, structurally and discursively constituted. While both Connell and Butler developed anti-essentialist theories of gender and, hence, masculinities, both bodies of work have some limitations. Connell’s theory can be seen as presenting a potentially fixed typology of masculinities, while Butler’s theory locates the constitution of masculinities mainly in discourses/ language (Connell, 2012). Bringing these two theoretical frameworks together, however, will enable me to study both the structural and discursive production of masculinities in historical and cultural contexts. These theories will thus provide useful insights into masculinities across generations and help facilitate a multi-layered analysis.

Mannheim’s theory of social generation

Finally, in order to add texture to my understanding of the historicity and multiplicity of masculinities, the concept of social generations is helpful. In common-sense understanding and also in the positivist social sciences, a “generation” may be conceived of as a concrete unit in terms of age cohort (Kecskemeti, 1952, p. 23). However, in his work Mannheim highlighted the limitations of conceiving of generations in terms of age and proposed that generations are formed through common experiences of key historical events and a certain shared consciousness (Mannheim, 1952).

Mannheim (1952) used the term Lagerung (which he translated as meaning location) to refer to the common features shared by a generation (p. 289). According to Mannheim, a generation is not a mere biological or statistical fact; it is rather a group of individuals who act and think in a particular way because they are located in the same place in a “structured” whole (Kecskemeti, 1952, p.23). Generations tend to have similar experiences, certain characteristic modes of thought, and a particular type of historically relevant action (Mannheim, 1952, p. 291). Examples of such a social generation may include the baby boom generation or the counter-cultural generation of the 1960s. Mannheim argued that the people who occupy a Lagerung do not necessarily form a “generation in actuality” (p. 303) or an actual generation. Instead, it is the case that, as Mannheim argues:

Individuals of the same age, they were and are, however, only united as an actual generation in so far as they participate in the characteristic social and intellectual currents of their society and period, and in so far as they have an active or passive experience of the interactions of forces which made up the new situation (Mannheim, 1952, p. 304).

As the research design was influenced by Mannheim’s work on social generation, three different social generations of men were selected to participate in this study. As mentioned earlier (chapter 1), the three social generations identified were the war generation11 (pre-1971), the post-war generation (post-1971) and the generation of the new millennium (post-2010s). I chose to study these three generations to explore if there

11 A nine-month-long war was fought between West Pakistan (now Pakistan) and East Pakistan (now Bangladesh) in 1971. The war led to the emergence of Bangladesh as an independent nation.

47 might be important differences and similarities in notions of masculinity and its enactments.

Research design and method

Congruent with the theoretical approach outlined above, I used a set of qualitative methods to answer the research questions. Such an approach is suitable for “exploring and understanding the meaning individuals or groups ascribe to a social or human problem” (Creswell, 2014, p. 4). It was deemed suitable for this study because I aimed at understanding the meanings men attach to the notion of masculinity across different generations. A qualitative research design seemed well-suited to an enquiry into the multiple ways men construct and enact their masculinities, the complex ways they conduct their gendered lives, and the meanings and experiences of sexual practices across different social generations. Semi-structure interview method, as detailed below, was utilised to capture men’s narratives.

Research sites and setting

The geographic area of Bangladesh covers an area of 147, 570 square kilometres and has an estimated total population of 159.96 million (Bangladesh Bureau of Statistics [BBS], 2014). The country is one of the most densely populated countries of the world, with over 1021 people living per square kilometre in July 2011 (BBS, 2013). The country became independent in 1971 after a nine-month long war with Pakistan (it was called West Pakistan before 1971). The Pakistani state was created in 1947, which marked the end of British rule in undivided India. While the Pakistani state was constructed around Islam, Bangladesh adopted principles of secularism, democracy, socialism and Bangladeshi nationalism. The adoption of these four state principles by a predominantly Muslim majority country may appear as unusual, given that some of these principles, especially secularism, are often considered incompatible with Islam. Using a purposive sampling strategy, narratives were captured from three groups of men living in three selected cities in Bangladesh – Dhaka, Chittagong and Gazipur. While Dhaka is the capital of Bangladesh and the centre of administration, commerce, business and education, Chittagong is one of the country’s two seaports through which most of the exports and imports from Bangladesh are handled. Dhaka and Chittagong are also

48 historic cities. Dhaka had first been made a provincial capital of the Mughal Empire in 1608. In 1905, Dhaka was again made a provincial capital of Bengal during the British period. Since the Independence of Bangladesh from Pakistan in 1971, Dhaka has remained the capital of Bangladesh, and has now turned into a megacity with a population of slightly less than 17 million (United Nations, 2016).

Chittagong is also historically significant as it was one of the first points of entry for Arab traders and Muslim saints, which has largely shaped its economic and cultural life. These saints and traders settled in and around the region, where they have preached Islam since the 8th century (Van Schendel, 2009, p. 27). The city is therefore often known as baro awliyar desh (the land of twelve saints). Many mazaars (religious shrines) are still located in and around the city. The anti-colonial armed movement against British rule by some historic personalities from Chittagong, such as Pritilata Waddedar, Master Da Surya Sen and Binod Bihari are well-known (Van Schendel, 2009, p. 80).

Gazipur, located on the outskirts of Dhaka, is mainly an industrial city. Like Dhaka and Chittagong, the city has a concentration of the country’s garments factories. All three cities have export processing zones (EPZs) from which garments and other products are exported to other countries. These three industrial cities are densely populated, as people have migrated and still do so for work and improved economic opportunities. By organising my study around these three cities, it was possible to recruit men from diverse social backgrounds, given the cities’ somewhat different social, economic, cultural, historical and political landscapes. In particular, people in Chittagong, living in the land of twelve saints and in one of the places where Islam was first preached in Bangladesh, are generally considered to be more religious and conservative than people in the other two cities included in this study. Dhaka and Gazipur are often considered to be more liberal than Chittagong. Dhaka, in particular, has a youthful population and the largest concentration of higher education institutions in the country. This city was chosen purposefully to recruit younger social generation men in order to examine potential differences in masculinities and sexual practices.

In addition to the justification above, the rationale for recruiting from these sites was also informed by the particular urban character of each site, which corresponded with

49 the kind of social and economic changes that typify the different generations. Guided by Connell’s and Butler’s theories, I anticipated that more diverse masculinities would be found in these three cities because each had experienced rapid transformation, of the kind which I myself had experienced. A further rationale lay in having professional contacts in each city who could potentially assist with recruitment.

My initial intention was to recruit men from all generations across all three sites, but for logistical reasons and access issues, each generation ended up being drawn from two of the research sites. In the case of the youngest generation, however, I purposely focused my recruitment efforts to universities in Dhaka. This was partly because I had good networks in that city, which was helpful with regards to recruitment. More importantly though, I specifically wanted to recruit young men with access to higher education because I was interested in exploring how young, educated, urban men who are connected to the global world might define and enact masculinity. It is worth noting that if younger social generation men had been recruited more evenly across the three sites, different findings may well have emerged.

Participant recruitment

The commencement of fieldwork (in the form of initial planning, contacting different organisations and advertising to recruit participants, travelling between these cities and interviewing etc.) was delayed due to unexpected political circumstances in Bangladesh in the latter months of 2013 and early 2014. Road blockades, vandalism causing damage to public property, and killing for political reasons marked this period; it was a time when the two major political parties could not agree on whether to hold the parliamentary elections under a non-party caretaker government. The political situation was further complicated by the trial of top leaders of the Islamist political party Jamat- e-Islami for alleged involvement in war crimes during the War of Independence in 1971, and Jamat-e-Islami’s opposition to the trial. Soon afterwards, however, the situation improved following the general election held in early 2014. I therefore started my fieldwork in April 2014 and completed it in mid-September 2014.

Given that sex and sexuality are perceived as taboo subjects in Bangladesh, entering the field and gaining access to participants was not always easy, requiring the use of several

50 different recruitment strategies. An advertisement for recruiting research participants was initially circulated through several non-government organisations (NGOs) and higher education institutions in all three research sites. The NGOs included Bonoful Samaj Kallyan Sanghstha in Chittagong and Bandhu Social Welfare Society in Dhaka. Both of them work closely with local communities to improve health of local populations. The higher education institutions were Chittagong University in Chittagong, and BRAC University located in Dhaka, and younger social generation men, in particular, were recruited by advertisements circulated in these universities.

A few potential participants from all social generations declined to participate in the study. The men concerned had initially expressed an interest to participate, but after learning more about the research topic, they later declined to do so. In most cases, reasons for non-participation were not known. Later on, however, I came to know from third parties and sometimes through my connection with male networks of potential participants (some of whom had earlier declined to participate) that one of the main reasons for some men’s non-participation was their involvement in pre-marital or extra- marital sex, which constitutes a violation of social, religious and sexual norms in Bangladesh. Besides this, shyness, the cultural taboo ascribed to sex, and concerns over privacy may have prevented men from participating.

Overall, recruiting men of the youngest and middle social generations proved easiest. Men in these social generations were economically active, were more mobile than older social generation men, and had higher literacy levels to be able to respond to the advertisement. In addition, since most of the middle social generation men were of my age, they considered me as a friend with whom sexuality matters can easily be discussed. In all, 11 men belonging to middle social generation participated in the study: eight men from Gazipur and three from Chittagong. With respect to the youngest social generation, 13 men took part in the study: 11 from universities located in Dhaka and two from a university in Chittagong.

The recruitment of older social generation men proved particularly difficult. I initially tried to recruit men of this social generation through specialised institutions, including homes for the elderly located in Dhaka and Gazipur. While most of the NGOs and universities I contacted assisted in circulating the advertisements, one of two old-age

51 homes I approached declined to assist with the recruitment of men from the older generation, while the other did not respond to my request, perhaps because of the seeming sensitivity of the research topic.

Since two homes for older people had declined to assist, and also considering the high illiteracy rate among men of this generation, snowball sampling had to be adopted. Several middle social generation men were requested to circulate the advertisement and to spread through word of mouth to potential older social generation research participants. Each older generation man interviewed was requested verbally to inform other potential older social generation participants about the research. I recruited 10 men belonging to the older social generation, with nine from Gazipur and one from Chittagong. One older social generation man from Chittagong who initially verbally consented to participate in the study withdrew on the very eve of the interview. With low literacy level and little understanding of the research process, he became sceptical of signing of the Participant Information Statement (PIS).

Semi-structured interviews

To answer the research questions, qualitative information was required relating to men’s construction of masculinity, their help-seeking practices, their sexual practices, their sexual health, and their enactments of masculinity in the arena of sexuality. Interviewing is a powerful qualitative research method that offers an opportunity to get closer to lived experiences, meanings and actions of research participants (Patton, 1990; Serry & Liamputtong, 2013, p. 40). Such an approach can be used to help people “make explicit things that have hitherto been implicit – [and] to articulate their tacit perceptions, feelings and understandings” (Arksey & Knight, 1999, p. 32).

There are three commonly employed types of interview: structured, semi-structured and unstructured (Mason, 2002, pp. 8-9). Positivist researchers commonly use structured interviews and surveys, but in line with the spirit of a constructionist and interpretivist approach, I adopted a semi-structured interview method. Semi-structured interviews provide a degree of flexibility when collecting data, unlike their structured counterparts, by offering the researcher “some latitude to ask further questions” (Bryman, 2012, p. 212). Using this method, researchers usually organise data collection around a set of

52 pre-set questions, but adjust the questions asked, ask more questions as they arise, and use probe-type questions when necessary to elicit further information during the interview (Berg, 2009, p. 141). As Bryman (2012) writes:

If the researcher is beginning the investigation with a fairly clear focus, rather than a very general notion of wanting to do research on a topic, it is likely that the interviews will be semi-structured ones, so that the more specific issues can be addressed (p. 472).

In this study, the use of such an approach provided a degree of consistency across the interviews by ensuring that fixed questions could be asked about masculinities and sexual health, while allowing both participants and myself the opportunity to explore other relevant concerns.

Men’s narratives were gathered through face-to-face, one-to-one interviews conducted at multiple locations in Bangladesh identified by the participants and myself as safe and convenient for both parties. These sites included offices, university/college classrooms, participants’ houses and my rented home office. Only one interview took place at a café. Each location was agreed upon by the participants before the interview, taking into account issues of safety, quietness for good recording, privacy and the protection of both parties from harm.

The duration of the interviews ranged from 40 minutes to a maximum of just under two hours, excluding informal conversation and discussion about the purpose of the research. On average, the interviews lasted about 60 minutes. Interviews with older and middle social generation men were generally longer than those with their younger counterparts. Older men had many more stories to tell (especially those of the 1971 war and different political regimes). On the other hand, middle generation men felt more comfortable than the other two generations because they and I belonged to the same social generation. These variations occurred mainly because of the level of disclosure with which the participants felt comfortable and the stories they were eager to share. Most interviews went relatively smoothly and without much interruption.

The process of interviewing

Building rapport and trust was an important first step in gaining access and to facilitate open communication and dialogue throughout the interviews (Dean, Wollin, Stewart, Debattista, & Mitchell, 2012, p. 913). Social research on men’s sexual health in a conservative, predominantly Muslim country such as Bangladesh is challenging, because sex and sexuality are considered sensitive and difficult subjects to talk about (Elam & Fenton, 2003). In order to deal with this matter, I used several strategies to encourage disclosure and reduce discomfort during the interview.

I paid careful attention to the ordering of questions in the interview guide (Appendix A). Following Patton’s (1990) advice, sensitive questions relating to sexuality and sexual health were asked only after discussion of other topic areas. First, attempts were made to build rapport with participants by interacting with them, and by talking informally to break the ice before the interview commenced. Next I collected some background information, such as age, occupation, work, and family life. I then asked some general questions about their work and ideas of being a man. These initial conversations have been described as “funnelling”, as they aim to gradually encourage participants to think about the research topic (Minichiello, Aroni, & Hays, 2008, p. 94). Discussion then turned to what might be described as key “turning points” in life (Minichiello et al., 2008, p. 111). focusing on important transitions, for instance, from boyhood to manhood.

Next, participants were asked about their romantic and sexual relationships with men or women. In this way, the interviews gradually moved on to more sensitive topics, with questions relating to sexual practices being asked at a later stage in the interview. These latter types of questions were asked to elicit information about sexual partners, the nature of sexual activities, the formation of sexual relationships, marriage, sex in and/or outside of marriage, condom use and so on. The interview guide was divided into different topic areas and questions were asked following the structure. Questions that are asked to move the conversation from one set of topics to another are sometimes called “structuring questions” (Liamputtong, 2013, p. 58; Serry & Liamputtong, 2013, p. 45). These questions assisted in moving from one topic area to another related to the research questions.

Active listening is an important aspect of in-depth qualitative interviewing (Liamputtong, 2013, p. 59; Serry & Liamputtong, 2013, p. 42). The use of open-ended questions meant that participants were able to narrate their stories without much interruption. Sometimes I kept silent and sometimes I just said “hmm” and “OK” to assure the participants that I was listening and that I was interested in what they were saying, thus encouraging them to carry on speaking. Other techniques used to enhance rapport included showing interest in knowing detailed information about the participants’ background and life history.

Occasionally, indirect or “projective questions” were used to elicit information on topics that were perceived as more sensitive than others. This type of questioning, which enquires into the attitudes and practices of “other people”, may offer insight into participants’ own attitudes and practices which they might not be prepared to speak about directly (Liamputtong, 2013, p. 57). Given the heteronormative, Islamic cultural context in which the research was conducted, I found it difficult to ask direct questions about whether participants had had any same-sex relations. Indirect questions proved helpful in eliciting useful information about same-sex relations from some of the middle and younger social generation men, without producing major discomfort or embarrassment. However, older social generation men provided only the briefest of answers to these kinds of questions, saying that they knew nothing about same-sex sexuality and claiming that they had never engaged in same-sex sexual relations. Overall, it was noticeable that participants grew more comfortable and more interested in the research as interviewing progressed. Towards the end and/or after the interviews, some participants told me that they had disclosed more than they had expected they would. As I had gained participants’ trust and confidence, several men told me that they had found it easy to tell me the “truth” or disclosed more than what they otherwise might do.

Participants sometimes sought to validate their answers with me, wanting to see whether I agreed with them on the question of the dhat syndrome (semen-loss) (Lakhani, Gandhi, & Collumbien, 2001) through nocturnal emissions, for example. There were moments when I disagreed, but I tried to hide my actual views so that participants could express their viewpoints freely and to make sure that participants did not simply answer

55 according to their understanding of my expectations. I felt that if I disagreed, because of differences in our levels of education and perceived status, they might not disclose their valid opinions and viewpoints.

Prompting techniques were occasionally utilised to elicit responses. I prompted by suggesting a possible answer to a question to the respondent (Bryman, 2012, p. 224). Many participants, for example, professed to having little understanding of the concept of jauno shaisto (sexual health) or of jauna rog (sexually transmissible infections [STIs]). Here, I prompted by offering possible definitions of jauno shaisto and by explaining the ideas of jauna rog in non-technical terms. This proved useful in eliciting more detailed responses. I occasionally asked probing questions such as, “Is it so?” or “Ok, tell me more about that” to elicit more information and to consider the answers in relation to what participants might have said earlier in the interview.

Note-taking and audio-recording are two common techniques of recording interviews (Miniechiello et al., 2008). In this study, all the interviews were recorded using a digital audio recorder in order to ensure uninterrupted flow of discussion, to be able to listen carefully and to keep the interview setting as natural as possible. For these same reasons, I avoided taking notes during the interviews, although note taking had initially been planned. Before ending each interview, I asked a series of “clearing house questions” (Minichiello et al., 2998) to make sure participants had talked about everything they wanted to, and giving them a chance to add anything extra. I also tried to pick up the main points emanating from each interview, and validated these with the participants. Finally, after each interview, I prepared a short case study description of each participant.

Making sense of men’s narratives: data analysis

While interviewing is a meaning-making process (Holstein & Gubrium, 2005, as cited in Berg, 2009, p. 104) in which the interviewer and interviewees co-produce data, the goal of qualitative data analysis is to “make sense out of the data” collected (Merriam, 2009, as cited in Savin-Baden & Major, 2013, p. 434). Data analysis often implies an iterative process, moving from small units of information to discover larger patterns in the data. In this study, I applied an abductive logic to describe social life first in terms of

56 the concepts used and meanings implied by research participants and then to develop theory iteratively from these accounts (Blaikie, 2007, p. 8). Unlike its quantitative counterpart, making sense of data or analysis in qualitative research starts right after entering the field. In this case, using a flexible semi-structured method offered me an opportunity to engage in some initial analysis during each interview itself. This informed the kind of follow-up questions asked of participants in relation to responses given earlier during the interview (Pole & Lampard, 2002, p. 190). In addition, and as mentioned above, immediately after each interview, I prepared brief notes while some of the most interesting points and pieces of information were still resonant in my mind. This process, called summative analysis (Berg, 2009). was part of my first attempt to make sense of men’s accounts.

I also prepared two tables while I was in the field. The first of these recorded social, economic and demographic information, such as age, occupation, marital and relationship status, and so on (see Appendix B). A second table summarised key information relating to gender relations, attitudes towards sex, sexual relationships and same-sex relations. These tables, together with my preliminary notes and case study descriptions of each participant, were useful to develop a better sense of the men’s narratives and to point to some of the main issues that later emerged from more systematic analyses.

While I was still in the field, I was able to begin a more systematic analysis of the accounts elicited. To inform this phase of analysis, all the interviews were transcribed in full. Interviews conducted in Bengali were translated into English while transcribing. A bilingual transcriber was appointed to assist with the transcription process. She was briefed on how best to translate and transcribe the interviews so that the essential elements of meanings remained almost the same. Therefore, explanations of these are provided where necessary when reporting the findings. Special attention was paid to the transcripts prepared by the appointed transcriber, as she was relatively inexperienced. Missing sections were incorporated and translations that are more accurate were carried out in places where this was deemed necessary.

While transcribing and/or cross-checking the transcripts, I noted important points and sometimes highlighted chunks of texts. Following transcription, the notes and

57 summaries written earlier were checked, modified, and revised where needed. The transcripts were subjected to multiple readings and were checked for accuracy.

Coding is an important phase in making sense of interview transcripts. Codes serve as signposts that offer a map or summary of detailed data through the identification of a series of themes (Pole & Lampard, 2002, p. 199). Coding also provides a means of “working with and building knowledge about data” (Bazeley, 2007, p. 66). I started coding while I was still in the field, and was engaging in initial analysis. This work involved slicing, sorting, and highlighting transcripts into different parts in order to organise and categorise them (Savin-Baden & Major, 2013).

To facilitate this work, all interview transcripts were uploaded into the qualitative data analysis software NVivo (version 10). Guided by the research questions, theoretical frameworks and key concepts used, I read each transcript and coded key text within each transcript. While doing so, I also prepared a series of analytical memos or notes. These highlighted some of key phrases used, the key local terms employed and the meanings of these terms.

In line with an abductive approach, the analysis involved discovering everyday gendered practices and meanings men attached to the range of issues explored in this study, including ideas about jauno shaistho (sexual health) or sottikarer purush (real men), help and health-seeking practices and so on. Based on men’s narratives and the concepts they used, theoretical insights were developed that were iteratively informed both by the overall focus of the study and the research questions it was intended to explore (Blaikie, 2007, p. 8).

The analysis of the interviews also involved assessment, explanation, and interpretation of the interview transcripts, paying attention to commonalities, similarities, contradictions and differences in the ways in which the men constructed masculinities and conducted their sexual/gendered lives. Applying constant comparative technique (Savin-Baden & Major, 2013, 436), I was able to focus on what men’s accounts revealed about how social generations differed (or not), with respect to understandings, constructions and performances of masculinities. Patterns as well as deviations from the

58 patterns were identified in relation to men’s understandings of masculinity, their sexual practices and health-seeking practices, which are reported in chapters 4, 5 and 6.

One limitation of the use of NVivo is the risk of losing sight of the context of participants’ responses. In order to overcome this shortcoming, chunks of transcripts that provided the context of a particular response were also coded. Beyond this technique, considering the men’s accounts in the wider social, political and historical context allowed me to overcome the limitations associated with qualitative data analysis solely with the aid of software such as NVivo.

Ethical considerations

Ethics approval for this research was obtained from the UNSW Human Research Ethics Committee (Reference number: HC 13307, see Appendix C). In addition, two academic departments at two universities in Bangladesh12 acted as local partners providing oversight of ethical matters, as there exists no national level social science research ethics committee from which guidance and approval could be sought. As required, annual reports were submitted to the UNSW Human Research Committee affirming compliance with the ethical standards set by the National Health and Medical Research Council (NHMRC) and adapted by each Australian university, such as informed consent, the safety and confidentiality of research participants and secure storage of data.

In general terms, informed consent, maintaining anonymity, safety, privacy and confidentiality, and security of data storage are key ethical issues that any social research study must address (Mason, 2002, p. 101; Gray, 2004, p. 61; Habibis, 2013, pp. 82-83). In this study, informed consent was obtained from participants by providing them in advance with easily comprehensible information about the investigation and the role and rights of the participants. Each participant signed a Consent Form (CF) to indicate their informed consent after reading a Participant Information Statement (PIS) (see Appendix D). Both the CF and PIS were translated into Bengali and their contents were also verbally explained before the commencement of each interview. The university students preferred to read the English version of the PIS and signed the

12 The University of Chittagong in Chittagong and BRAC University in Dhaka.

English version of the CF, while all other participants read and signed the Bengali version. Two illiterate men from the older social generation, who were not able to sign, put finger impressions on the CF to indicate their consent and their verbal consent was audio-recorded. I read out the PIS and the CF to each of these two men before obtaining their verbal consent. Participants were also informed about how their information would be stored and used in the thesis and any subsequent publications.

Participants were given a chance to decide whether or not to participate in the study or withdraw from the study at any time. This piece of information was also mentioned in the PIS and CF and was verbally explained where necessary. No participant who signed the consent form did, in fact, withdraw from the study. However, some men from all generations who initially expressed an interest to participate in the study later opted not to do so. They had read the PIS and/or the advertisement and had called me or emailed me to discuss the possibility of their participation. Some wanted to know about the possible benefits of their participation in the study. Not seeing any immediate personal benefit, they may have decided not to participate in the end. Other reasons for non- participation were not given. However, after spending time in each of the research sites and interacting with the local community, I came to suspect that another reason was men’s engagement in pre-marital and extra-marital sex.

In addition, data were anonymised and steps were taken to ensure confidentiality and privacy. All interview transcripts were de-identified and anonymised prior to transcription to protect the identity of interviewees. Prior to being de-identified, digital audio-recordings were stored electronically and protected via password encryption on a restricted-access drive on the secure UNSW network server. The transcriber, who was required to sign a confidentiality agreement, deleted all files (including audio recordings) following transcription.

To compensate participants for their time and travel costs, a small amount of money (Bangladeshi taka 500 = about $AUD 10) was paid as reimbursement, a sum lower than that originally suggested, on the advice of the UNSW Human Research Ethics Committee, to ensure no undue inducement for participation in the research. Given the time and lost income for most low-income older and middle social generation men for their participation, the small amount was considered fully justified.

Finally, all participants were offered an opportunity to express their willingness regarding whether they would like to receive a summary of the major findings of the study. Most men from the younger social generation and some from the middle social generation took up this offer. All participants were also informed that their quotes and information might appear in publication in the future, but that pseudonyms and anonymised data would be used to protect their identities.

A note on reflexivity

In exploratory qualitative studies such as this, reflexivity is of fundamental importance. The term reflexivity is used to refer to “self-conscious awareness” of a researcher’s position and his/her active engagement in the research process (Willis, 2013, p. 317). “In disciplines that take for their subject matter some aspects of human society [the] phenomenon of reflexiveness is quite inevitable” (McCall, 2006, p. 4). That said, in spite of the emphasis currently given to reflexivity and the rapid growth of research within the field of men and masculinities, relatively few researchers have adequately addressed the issue of reflexivity in their research on men (Pini & Pease, 2013, p. 1). What Haywood and Mac an Ghaill (2003) observed over a decade ago still appears to be true: “In fact, sustained methodological discussions of masculinity have yet to take place” (p. 121). As Pini and Pease also (2013) put it:

Notwithstanding the growth of this scholarship [studies of men and masculinities], we have been struck by the relative lack of interrogation of the epistemologies and methodologies involved in the study of men and masculinities ... masculinity scholars have generally not problematized the methodologies they have chosen to research men’s lives (p.1).

By way of contrast, feminist research (Beasley, 2013) has been characterised by a relatively well-developed methodological literature called feminist methodologies. Feminist authors constantly seek to interrogate the methods they have employed, acknowledging the power relations between researchers and the researched, and providing critiques of conventional research practices, which, for them, often fail to register women’s voices (Pini & Pease, 2013). Major debates have ensued within feminism about relevant ontological and epistemological issues, but the field of men and masculinities has remained largely immune to these developments (Pini & Pease, 2013, p. 5).

Researchers’ gender, power relations, ontology, epistemology and theoretical orientations are important methodological issues in masculinity studies (Petersen, 2003; Haywood & Mac an Ghaill, 2003; Flood, 2013). It is therefore important to acknowledge the ways in which I as a researcher conceptualised and conducted the study, as well as my personal relationship to the field. I am a heterosexually married Bangladeshi man, raised in a low-income (which has graduated to lower-middle-income country in 2015), predominantly Muslim country. Bangladesh is a highly heteronormative, patriarchal country in which greater gender equality is being achieved through planned programmes of social change. Having had exposure to other cultures, being educated in a range of Western social science disciplines, and having worked for non-government organisations, policy research centres and higher education institutions, I am constantly negotiating my identity. I chose to study men’s health in Bangladesh because of my national background. My nationality, gender and knowledge of the Bengali language certainly offered me the opportunity to navigate through the fieldwork relatively comfortably. For example, as Bangladesh is largely a sex-segregated country in which cross-sex conversation about sexuality rarely occurs, being a man worked to my advantage when talking about sexuality issues.

Hearn (2013) has argued that ontological ideas “have implications for what is seen, the data gathered, the mode of analysis, interpretation and so on” (p. 34). Ontologically, slightly different knowledge may be available to men than to women. Similarly, pro- feminist men and women may have access to different knowledge than their anti- feminist or non-feminist counterparts. Therefore, being a Bangladeshi gender-sensitive man trained in Western social science disciplines and research methods meant that different knowledge about the research issues discussed here was more available to me than to most study participants. Ultimately, therefore, I have conceptualised and conducted this study on masculinities and sexual health in a particular way. Having read Connell, Butler and Mannheim, whose work theoretically informed this study, I have come to understand gender, masculinities and social generations in ways that are different from the more reductionist understandings of gender represented in popular media and in the works of many academics, development practitioners and researchers in Bangladesh.

Prior to embarking on this study, I had studied sociology at the University of Dhaka in Bangladesh and development studies at the University of Auckland. As discussed in the “personal underpinnings” section in Chapter 1, I developed a keen interest in the social studies of health while studying these subjects. My background in these subjects influenced the conceptualisation and analysis presented in this thesis. In particular, my thinking was informed by key concepts from within these disciplines, including social generations, heteronormativity, gender, and globalisation, which enabled a particular way of engaging with and understanding the topic of my study. Given my disciplinary background and prior research, methodologically, I was drawn to the interpretivist and a qualitative research approach.

Although I was born and raised in a predominantly Bengali Muslim culture, I have lived in different countries such as Thailand, New Zealand and Australia, which has offered me an opportunity to view my own culture both as an “outsider” and “insider”. I was thus able to see the familiar both as a non-native and as a native, often being able to rethink, if not question, cultural assumptions and practices and religious beliefs. For example, I was aware that discussing sex and sexuality topics could produce discomfort during the interviews in the Bangladeshi cultural context. While reflecting on my first few interviews, I realised that I had unnecessarily avoided asking directly about men’s possible sexual relations with other men or hijras. However, I did correct myself and revised the interview guide to include more specifically the topic of same-sex relations, while being mindful of the cultural sensitivities around this topic. I also noticed that most heterosexually active men held heterosexist and heteronormative assumptions that often became evident during the interviews. Like them and many others in Bangladesh, I used to hold similar heteronormative assumptions, which I could question only because of my exposure to Western cultures and Western gender theories.

Like many researchers from the Global South, I have been heavily dependent on Western knowledge for the theories and concepts that inform what follows (Connell, 2014). I went back to Bangladesh to conduct the fieldwork with a degree of understanding of the research topic, some theoretical background, and an exposure to Western culture and knowledge. I had also reviewed both the international and South Asian literature on the subject, which meant that I was aware of local situations and local understandings of cultural and sexual practices. Although I attempted to be led by

63 the realities that I encountered in the field, I noticed that my prior knowledge about the subject, the theories that I used and my cultural assumptions all influenced the research conversations – in accordance with what in the West is called an informed and abductive approach.

I also noticed that my understanding of masculinities or sexual health was largely different from those of the participants I interviewed. For example, while translating the PIS, even though I consulted several dictionaries, I could not find a suitable Bengali term to translate the English concept masculinities as I understood it. This required me to explain the meanings of the concept to participants in non-technical terms. In the process I did, however, came across terms such as purushali achoron (manly behaviour), sottikarer purush (real man), purusotto (manliness) or betar moto beta (a man like a real man) which, while locally relevant, were far from the meanings associated in the Western literature with the key concept masculinities. In addition, participants had little or no understanding of the concept of jauno shaistho or sexual health. Participants and I therefore had to use a variety of local terms to discuss the research topics that were the focus of my research.

Power is an important ethical and practical issue that emerges throughout the research process. Although I set the agenda of the research study, having access to research training and skills as well as the relevant literature, the research participants were not necessarily powerless. Given the circulatory and fluid nature of power, there were occasions when participants asked questions about the research, requested clarifications, refused to answer particular questions and provided very brief answers (in relation to pre-marital, extra-marital sex for example) and so on. Thus, they too exercised power by refusing to answer too sensitive questions relating to attitudes towards same-sex relations, intimate partners, sexual encounters that transgressed norms of acceptable sexual behaviours, and so on. One particular heterosexual man refused to disclose where sex with his girlfriend had taken place, as this was an instance of pre-marital sex, which was not socially acceptable and had occurred secretly. Another younger social generation man similarly did not answer a question about whether he thought his engagement in pre-marital sex was in line with Islam. He requested me not to ask any further questions about religion (in relation to sex) when this issue arose during the interview.

Research can be a site for the production and expressions of masculinities (Hearn, 2013) and for impression management (Goffman, 1956). Most participants and I myself seemed to engage in, what Goffman (1956, pp. 132-151) has described as “impression management” or “face-work”. While I may have presented myself to the participants as a serious researcher, an active listener, and a concerned citizen, the men tried on occasion to present themselves as ethical, moral persons, good Muslims and as acting within the cultural boundaries of acceptable sexuality. This interaction in turn undoubtedly influenced what was (and was not) discussed in the interviews. The ways in which the presence of the researcher and the research process impact on participants has long been known as the Hawthorne effect (Habibis, 2013, p. 86).

However, several participants told me that they also felt the need to “tell the truth”, which may be an unwitting consequence of the seriousness that they believed I had shown. It seemed to me that for many participants the interviews were also an empowering experience because they could (perhaps for the first time) express their opinions, experiences, feelings, and ideas about men and masculinity, and have their voices heard. For this reason, perhaps, some older social generation men added towards the end of their interview that they had told me the “whole story” of their lives, indicating that they provided all relevant information and had nothing more to add.

In this chapter, I discussed the philosophical and theoretical underpinnings of the present study. I discussed how I used semi-structured interview method and techniques to capture men’s narratives from three social generations of men. Men’s accounts offer deeper insights into Bangladeshi men’s construction of masculinity, their sexual practices and health and help-seeking practices. The next chapter discusses the main elements of social generational masculinities based on men’s narratives.

Chapter 4: Making a man: generational masculinities

Introduction

Findings from this study point to similarities and differences in the ways in which masculinities are understood, constructed and enacted by the men of the three social generations interviewed. Together, they highlight the importance of historical, cultural, social and economic factors in the production of forms of masculinity. Historical events such as the Partition of India and the creation of the Pakistani state, and the Liberation War of Bangladesh, among others, influenced older generation men’s understandings of themselves and their enactments of masculinity. The self-perceptions of middle generation men, on the other hand, appeared to be influenced largely by economic globalisation and increasing urbanisation in post-independent Bangladesh. Cultural globalisation, information and communication technologies (ICT) and the impact of higher education played important parts in shaping the understandings of masculinity among younger generation men.

This chapter is organised into four main sections. The first section provides some general background information about each of the three social generations studied. The second section discusses understandings and self-perceptions of masculinity among older social generation men. This section is then followed by a discussion of middle social generation men’s ideas and enactments of masculinity. The next section focuses on masculinities among younger social generation men. The chapter concludes with some insights on the findings presented.

Three social generations

At any particular moment in history, typically up to five or six social generations co- exist and it is often difficult to precisely demarcate and name social generations due to rapid social change (Plummer, 2010). Therefore, members of a social generation do not necessarily fit neatly into any one specific generational category. This has been described as the “boundary” problem in social generational study (Pilcher, 1994, p. 487).

Boundary lines along social generational categories are therefore to some extent constructed by researchers. Doing so generally depends on a researcher’s interest(s), the purpose of their enquiry, their understandings of historical events and how they define different generations (Pilcher, 1994). In the present study, after each interview, I allocated participants to different social generations based on their accounts of the historical events they said they had experienced. While most participants in this study fitted quite comfortably into generational categories, difficult decisions had to be made about a few participants who seemed to fit into two generational categories. In the case of these men, the decision to allocate them to one of the generational categories was influenced by their experience of certain key historical events and the most prominent themes in their narratives. This explains in what follows the sometimes wide age range within a social generation and the narrow age gap between members of different social generations.

The older social generation included men who reported that they had experiences of growing into adulthood in the early 1960s and 1970s under autocratic Pakistani rulers (especially General Ayub Khan) and during the Liberation War of Bangladesh. Those who were assigned to the middle social generation were born in the period leading up to and after the Independence of Bangladesh from Pakistan in 1971 and had experience of Bangladesh’s autocratic rulers during the country’s transition to democracy in the 1990s. Their life experiences were also profoundly shaped by growing up in the post- independence era of economic globalisation, with its liberalisation of the Bangladesh economy, rapid rural-urban migration and the rise of the garments industry in the 1980s. Finally, younger social generation men were born in the mid-1990s onwards and grew up in the post-2010 period; a period marked by accelerated cultural globalisation, ICT innovation and greater access to the global media and higher education. I purposefully recruited men of this social generation from universities located in Dhaka and Chittagong.

In this study, the 10 older social generation men interviewed ranged in age from 53 to 75 years old, although many did not know how old they were. Because of old age and/or ill health, many could no longer work or only worked part-time. Most belonged to low- income groups. Two men could not sign their names, while others could, but none had

67 completed their primary education. All were either married or widowed. All identified as Muslim. Religious practices varied from one person to another, with some men reporting more frequent involvement in religious rituals such as namaz (prayers) than did others. In addition, while some men mentioned that they participated in Muslim organisations such as the Tabligh Jamat (an organisation of pious Muslims, who encourage others to perform their religious duties regularly) and the mazar (shrine of Muslim saints), others did not cite any such religious involvement. However, their accounts also indicated that differences in religious practices could vary across different stages of men’s lives.

The 11 men who belonged to the middle social generation ranged in age from 30 years to 51 years, but most were in their thirties. All but one identified as Muslim, with Dulal (46, office assistant) identifying as Hindu. All were married and had children. Although most men of this social generation had been born in rural villages, they had migrated to cities to find work. Given their generally low levels of educational attainment, they worked as office assistants, van drivers, rickshaw pullers, electricians, factory workers, street vendors and day labourers. Two participants, who held masters degrees, worked as college teachers. Other participants’ highest qualification was the Secondary School Certificate (SSC) awarded after the 10th grade. Except for the two college teachers, men reported that they lived on low incomes and found it difficult to provide for their families. Most of these men lived in one-room rented houses in low-income areas known as basties (slums) in the cities.

The effects of Western culture, advanced telecommunication technologies, international migration and higher education, the Internet and social media were most pronounced in younger social generation men’s lives. These participants were between 19 to 27 years old. Most were university or college students, two were recent graduates, and one worked as a security guard at a college after having dropped out of school. Of the 13 participants from this generation, 11 identified as Muslim, one as Hindu, and one professed not to believe in any form of religion. Only two of these men were married.

Masculinities in older social generation men

Religion and spirituality played a crucial role in the production of masculinities among older generation men. Most older social generation men talked about their regular involvement in religious rituals, such as namaz (prayers), fasting, and going on religious tours. Adil, for example, was a 75-year old retired man who lived in a mosque and spent much of his time performing namaz and attending jamat (religious tours). He had become a member of tabligh jamat. Several older men reported their spiritual affiliation with a particular mazar or religious shrine. For example, Forkan (about 55 years, rickshaw puller) mentioned that he prayed both to Allah (the Creator and the Almighty according to Islam) and to Baba Shah Jalal, a highly revered pir or Muslim saint in Bangladesh. In contrast, although middle and young social generation men identified themselves as Muslim, they did not cite engagement in religious rituals to the same extent that older generation men did.

Older social generation men stressed the need to be what they viewed as a “good” Muslim man. This finding was consistent with their more passionate engagement with religious ritual, as mentioned above. Leading a life according to the formal codes of Islam, including honesty, doing good deeds, maintaining distance from unrelated women, and not having pre-marital or extra-marital sex were cited as important qualities. Older social generation men viewed pre-marital or extra-marital sex as “bad” and non-heterosexual sex as sinful. Bazlul, who was about 70-75 years (he did not know his exact age), described how he had acted according to his father’s advice throughout his life. His father had been a sadu (good man) and a fakir (honourable, respectable religious man) who advised him to lead a good life and not to do any misdeeds, which included pre-marital or extra-marital sex: “We’re sadu people. My father was a fakir … He got me married at younger age. He said, “Don’t do bad things. Lead a good life”.

In Bangladeshi society, as in South Asia more broadly, family honour is taken seriously. As the quotation from Bazlul indicates, families that provide traditional and spiritual healing are regarded as honourable, especially in rural Bangladesh. As a fakir, Bazlul’s father had enjoyed respect and honour, which would have been compromised had Bazlul engaged in practices that transgressed the boundaries of dominant social and sexual norms.

In the arena of sexuality, older social generation men cited sexual prowess as an important manly characteristic. Interviews suggested that sexual strength, as demonstrated through a successful and sexually satisfying marriage, was constitutive of an ideal form of masculinity. Mohaddes (53 years, rickshaw puller) indicated that being able to satisfy a wife sexually was an important aspect of manhood:

Suppose ... a man doesn’t have money and property, nothing. But his purusango [penis] is all right, like that of a beda [a man]. Suppose, he can penetrate for 10, 15 or 20 minutes. They [sexual partners] did anondo [had pleasure]. Both have met their tripti [sexual urges]. That’s it … A man should have the ability to last for, say, 15 to 20 minutes.

Older men insisted that melamesha or milon (both terms meaning sex) should only occur within marriage, in line with dominant Bangladeshi cultural and Islamic values. Some fondly reminisced about having once been sottikarer purush (real men), especially when they were younger. Mozammel remembered a night after his marriage when he had had six sessions of sex with his wife. He said that he had “dug” her repeatedly, indicating his sexual prowess and power. His use of the verb kopaisi (to dig) relates to the practice of digging soil for growing crops in the agriculture-based village economy that Bangladesh relied on in his young age. Similarly, Mobin was initially hesitant to talk about his sexual experience, thinking I was too young to be told about such things by an older man. However, after being assured that I would not mind, he said:

Your relationship with me is one of uncle and nephew [therefore, he was not supposed to say what he said subsequently) … OK, well, there was a time when I used to start having sex at 12 at night, and the whole night was spent there until the azan of fazr [call for early morning prayers time].

As the above quotation suggests, older men told these stories of long sex sessions to indicate how well they lived up to the notion of sottikarer purush. In their old age, however, many of these men reported being no longer sexually active because they had been suffering from disease or various forms of disability. As a result, they no longer felt sottikarer purush in sexual sense. Bazlul explained why he no longer saw himself this way: “Because I can’t see well. When we two old people get together, we don’t do what we used to do [i.e., sex]. What we do is simply eating and sleeping. There’s no melamesha [sex]”. For Bazlul, poor eyesight was indicative of the weakness that meant he was no longer able to have sex with his wife.

Being physically strong, especially having a strong body and sexual capability were aspects of the masculinity espoused by many older social generation men, for whom disease and disability posed a threat to the body and to their self-understandings of being a man. As men aged, their notions of themselves as men changed, indicating the provisionality and temporality of masculinities within this context. Findings further suggest that men took up other forms of masculinity as they grew older and were no longer sexually active. Some men of this social generation, for example, wanted to become better Muslims by becoming more religious.

All men of this social generation mentioned having been solely in heterosexual monogamous marital relationships. The main reason for this was that they aspired to adhere to what they saw as a “good” married Muslim man (i.e., not having sexual relationships outside marriage), being a tabligh jamat man or being the son of sadu (respectable, honourable) family.

Although older men seemed to have little concept of either homosexuality or heterosexuality, after explaining the concept briefly to them, they expressed homophobic attitudes, viewing somokamita or homosexuality as a “sin”. It was explained to them that some men in Bangladesh engage in same-sex practices. They said that they had not known anyone who had had same-sex sex, and claimed that they themselves had never engaged in such practices. They believed that homosexual behaviour ran counter to the teachings of Islam and conflicted with norms of Islamic masculinity. They took for granted that marriage was the primary institution around which sexual life was organised in Bangladesh. Their accounts revealed how heteronormativity may render invisible both the “heterosexualness” of marriage and the existence of same-sex sexual relations.

Mohaddes linked his disapproval of homosexuality to his understanding of creationism. According to Islam, Mohaddes explained, Allah had first created Adam and Hawa, the first man and the first woman, from whom all men and women were later fashioned. Mohaddes believed that Adam and Hawa had been sent down to the earth from heaven. He explained as follows why he thought same-sex relations were not “right”:

Because when Allah sent people first - Adam and Hawa, if it [same-sex relations] was right, there wouldn’t have been such a pair. There had been either

only men or only women. Why did he create both men and women? [That’s] because they both will match well. How can two of the same jat [caste or sex] match? How can men and men, and women and women match? So for this reason, from my own understandings, I think, it [same-sex relations] isn’t right.

Mohaddes’s description points to the importance of religion in most older social generation men’s explanations of the world. Significantly, Islam has been an important social institution in Bangladesh for over a thousand years, shaping and structuring sexual, ethical, legal aspects of the country, and its powerful influence was still clearly evident in the views expressed by men in this group.

Hard work was another important issue for these men. They cited working, earning money and providing for the family as other key constitutive characteristics of masculinity. When young, most had worked on their father’s farm and/or as agricultural labourers in their villages. They had grown up in Bangladeshi villages, which were historically described as “little republics” relatively unaffected by external influences. In these settings, agriculture had been the main means of subsistence and men’s power and status were largely dependent on land ownership. Most research participants tended to work outside the home. Women had few opportunities for movement and were married off at a relatively early age. Men enjoyed privileges as head of the households and honour as village headmen. Men belonging to a lower social-economic status worked as agricultural labourers to provide for their families. Adil used to work on his own family land and produced enough crops to support his family, thus demonstrating a well-respected form of masculinity in this setting. However, after losing his land to river erosion, he had become a kamla (agricultural worker needing to work on someone else’s farm in exchange for money). His loss of land also meant the loss of manly power and prestige. Therefore, he said he had started to think of himself as a kamla, which connoted a less honourable form of masculinity in his village settings.

Amir (55-56 years, security guard), like other men of this generation, emphasised that he had had to work hard to shoulder the responsibilities of being a provider. He recalled periods of working very hard to earn a living. Mobin similarly emphasised the importance of work in his life, saying that his hard work had allowed him to survive and provide for his family during times of ovab (scarcity), by which he meant the famine that killed many people in the country in 1974. Mobin had had to migrate to Dhaka to

72 look for work during the famine. He had initially worked as a gardener at a lawyer’s house, but he left the job because one day the lawyer’s wife had asked him to massage her legs – a job Mobin had disliked because he saw it as unmanly.

That was a long time ago. It took me one month to clear the bush and turn it into a garden. I also worked in the construction [as a security guard]. An advocate had asked me to remain in his house and offered a job to work as a servant. But I said, “I will go home. Please give me some money”. He gave me money and 20 kilos of wheat. I went home with the wheat by train. It was the time of ovab. People had been suffering much. After staying a while [in my village], I went back to the house of the advocate. His wife was not good. She asked me to do dirty jobs ... We have to support songsar [family]. Work is everything to us.

He later migrated to another city where he worked as a servant and agricultural worker. Men as household heads are responsible for providing family maintenance in Bangladesh and Muslim family law states that a woman can divorce her husband if he fails to provide maintenance.

Similarly, Akkas (70 years, cook) believed that a man who was not able to work was not a sottikarer purush (real man). The strong association between work and masculinity and the idea of work as a specifically masculine domain was evinced by many older social generation men’s disapproval of women taking up paid work outside the home. Akkas believed that cooking in the family context was a woman’s job, while cooking for community events such as a funeral or marriage ceremony that generates cash was a man’s job:

It’s important. I think the home is for women. They should not work outside the home; they should be at home. No matter how hard it is for men, they should work hard and bear household expenses and feed them [women]. Nowadays women are going out and working. Men are also working. That women will go out, it’s not there in the Hadith [the Prophet Muhammad’s instructions], nor is it mentioned in the Quran. It’s the duty of a husband to protect her and to provide maintenance. It’s important that men bring food home and feed women.

Similarly, in Amir’s opinion, the role of a woman should be that of a ghoroni (someone who stays and works at home). In addition to these aspects of “proper” masculinity, some older generation men stressed the importance of responsible fatherhood, describing how proud they had felt when their children were born. Childlessness posed a real challenge to masculinity, as was the case for Amir who felt that he was

“imperfect” because he could not have any children, especially sons: “I’ve some lacking. I couldn’t have children. Maybe that’s my bad luck. For this reason, I’m a bit choto [imperfect as a man]. I’ve some regrets because a son may not provide maintenance, but if I die, he can put soil on my grave”.

Sons are generally desirable in Bangladesh where, in the absence of social security and in a context of profound gender inequality, they have traditionally played an important role as labourers, as providers in old age, and as the inheritors of property. In rural Bangladesh, a large number of sons was traditionally seen as a source of influence that could protect a father’s land from powerful enemies. However, among these older social generation men, sons were valued not just for the labour they might provide but also for their ability to perform the cultural rites necessary at cremation.

Halim was also childless. Both he and Amir had visited kabiraj (traditional healers) and doctors in an effort to address the issue, but without success. They expressed despair about their inability to have children. Halim, for example, said:

So from age eight years to date my life has been going through all these sorrows and sufferings. Now there is none but Allah to understand my sorrows. Because of these sorrows I pray and cry. Why did Allah make me so? Why did he make me so hotovhaga [unfortunate]? Do you understand? This is what I’m going through. I saw many doctors, kabiraj, and I did it [diagnostic test] for myself too. This is basically my fault.

Halim expressed a sense of not being able to do anything about the sorrow and suffering that resulted from infertility. He indicated that he had seen doctors but that infertility was his “fault”, not his wife’s, which posed a challenge to his self-understanding as a man.

In contrast to middle and especially younger social generation men, technology and mass media played a minimal role in the making of older social generation masculinities. Most older social generation men did not report watching television and some even saw watching television as un-Islamic. Many of these men did not use a mobile phone either. However, some reported enjoying jatra, a form of traditional Bengali theatre with face-to-face acting and dancing. Going to jatra at night with other male friends in villages was the most commonly cited means of entertainment for older social generation men when they were younger.

The 1971 Liberation War occupied a prominent place in narratives of masculinity among men of the older generation. Many had memories of autocratic rule prior to the Liberation War and the independence of Bangladesh from Pakistan. Many had felt subordinated under Pakistani regime and also during the War. Some men felt vulnerable and put down when armed Pakistani soldiers had arrested and interrogated them, although they also felt lucky that they had not been killed during the War. Several older men had fled to India and had lived there as refugees during the nine-month long war in 1971. They said that they had seen villages being burnt by Pakistani soldiers and their Bangladeshi collaborators. Akkas said that he had seen dead bodies floating in the river during the War and regretted that he could not join the War as a “freedom fighter” and thus engage in a more “heroic” form of masculinity; other duties, such as providing for his family, had prevented him from doing so.

Very few older social generation men reported taking part in the War in ways that provided them with the opportunity to enact a brave form of masculinity. These men had not taken part in armed battles, but had assisted Bangladeshi guerrilla fighters by spying and sharing information about Pakistani soldiers. Kashem (75 years, retired) explained how he had helped the mukti bahini (Bangladeshi liberation forces):

The muktis used to keep in touch with us. They used to ask us about the whereabouts of the Punjabis [Pakistani army]. I’d secretly gone to the camp of the muktis and had told them the whereabouts of the Punjabis. The muktis had encircled them and had shot all of them to death. They’d killed many and there had been many dead bodies lying all around the camps.

Similarly, Mozammel (72 years, retired) had assisted Bangladeshi guerilla fighters by offering them food. Fear for his life prevented Halim (70 years, a caretaker and security guard) from going to the War, despite having had his name listed among the muktijuddhas (freedom fighters). He regretted during the interview that he could not do anything for the country, adding that he had to take responsibility for his old mother, brother and sisters after his father’s premature death.

Most older social generation men also reported that they had not got into fights in other (i.e., non-war contexts) times. Mozammel, for example, had seen much violence between supporters of two workers’ organisations at a jute mill, but he had never joined

75 any of the groups. He enjoyed prestige and appreciation as a flute player and had often entertained both factions by playing flute in the large factory that employed thousands of workers. For this reason, he did not get into fights. His narratives suggest that a small proportion of workers who wanted to gain control of the factory used to enact a violent masculinity.

In summary, findings suggest that notions of masculinity among older generation men took shape in the context of the political, religious, economic, social and cultural relations that have traditionally characterised Bangladeshi society. Heterosexual marriage, sexual prowess, hard work, fatherhood, being a good provider and being a “good” Muslim were the most important aspects of masculinity among older generation men. In contrast, lack of sexual prowess, infertility, diseases and weakness related to old age posed challenges to men’s understandings of themselves as men especially in their old age.

Masculinities in middle social generation men

Middle social generation men grew up from 1971 onwards under the influence of economic globalisation, increasing urbanisation and migration in post-war, post- independence Bangladesh. These new conditions provided both economic and sexual opportunities for this generation of men, especially in urban areas. Many reported having worked in the country’s garments factories, which boomed as a consequence of global demand for cheap labour. Other men of this generation had worked in informal urban economic activities, such as rickshaw pulling and van driving.

Historically in Bengal and Bangladesh, especially from the 19th century onwards, educated middle-class men employed mainly in government jobs provided a powerful model of hegemonic masculinity. Middle generation men in this study expressed frustration over their inability to fit into this model of Bangladeshi masculinity because of their engagement in low-paid urban occupations in a highly stratified urban society. They attributed their lower position in the occupational hierarchy to ovab (scarcity), which prevented them from accessing better education and getting a white-collar job. It was because of ovab that many of these men had migrated from rural areas to urban areas to find work. Mazid explained his situation:

Two and a half years ago, while I was not getting a job, I was working as a construction worker and painter for some time for the sake of my family. I had to support the family. I had to pay rent. I used to earn 200 taka [about $US2.50 dollars] by working a full day. I did this job for three months. I asked people to pay me some money to buy a rickshaw. Someone said, “Don’t buy a rickshaw, better sell tea”. I didn’t have money to buy a flask to sell tea. I was working in the construction and in the meantime a foreign company started its factory here. I took a job there. I went there. I saw that there were movement, protest and fighting. I was not getting my wages. I was paid 3000 to 4000 [taka per month]. It’s not enough money to survive.

Although economic conditions prevented middle generation men from enacting the kind of hegemonic masculinity described above, work nonetheless remained an important marker of masculinity. Like the older men, the middle social generation men said that work was important to them and most hoped to do better or earn more money in their respective occupations. As they did not have adequate formal education, they engaged in low-paid urban occupations that required mainly manual labour. Their engagement in manual labour enabled them to develop a sense of manhood. Despite being born into a farmer’s family, Shahit (34-35 years, factory worker) felt good about his ability to perform a variety of work:

I moved to Dhaka from [another district] and started working at a garment factory. I was in one for eight years and then at another for four years. I spent a whole epoch there. I left the job five months ago. But I’ve been driving auto rickshaws for a while now. However, that too has stopped for a while because the government has banned it due to the heavy consumption of electricity.13 But we still drive them illegally. So I still make my livelihood some way or the other by the grace of Allah … Yes, I can do almost everything. I was born in a farming family. I was into dyeing for four years too.

Regardless of the type of work he had done, work enabled Shahit to earn a living and he felt proud of his ability to do a variety of tasks. Since work was crucially important to the production of masculinity, periods of unemployment, or the inability to earn money posed a threat to middle social generation men’s understandings of themselves. Masud believed that money was the source of a man’s power and strength, as is made clear in the following quote:

I wish I’d more money. I feel a bit bad about that. I don’t feel manly enough due to this financial hardship. Some people have hundreds of thousands of taka. If

13 The government had banned the use of rickshaws that operated on batteries, which need to be charged by electricity. Most rickshaws are manually pulled in Bangladesh, while auto rickshaws operate on compressed natural gas.

I’d only one or two hundred thousand taka, I would have been happy. We don’t need much money. I feel durbal [weak]. I don’t have as much as others do.

As Masud’s comments suggests, middle social generation men in this study positioned themselves largely in relation to other men who had more money, power and higher rank, indicating that for members of this generation, there was a clear hierarchy of masculinities. In the context of their relatively lowly positions in the work hierarchy, middle social generation men sometimes developed different strategies to preserve a sense of manhood. One strategy among some men in this generation was that of leaving a job and/or refusing to accept what they saw as subordinate roles within the work hierarchy. Shahit mentioned having left his job in a garment factory after being verbally abused for a mistake he had made. Later he started to work as a rickshaw puller and occasionally a day labourer. Khairul (34 years, street vendor) also described resigning from his job when a new manager at his company fired him from a supervisory role and offered him a lower paid manual job instead. The manager had claimed that Khairul did not have the skills and literacy suitable for his role as a supervisor in a garments factory. Because of this perceived slight, Khairul had felt insulted and had not taken up the offer.

Although many men of this generation felt that they failed to aspire to a hegemonic form of masculinity (i.e., middle-class work), they drew upon other sources of evidence to assert their claim to other forms of hegemonic masculinity. As marriage and religion are two of the most important social institutions in Bangladesh, most middle generation men believed, as did the older social generation men, that a married sexually active Muslim man represents the ideal model of masculinity. In addition, a “real” man should also be a good provider for his family, have strength and money, and be good to Allah – or, in Masud’s (37 years, van driver) words, “A real man should be an all-rounder”. To cite another example, despite his low educational achievement and low-paid job as an office assistant, 35-years-old Islam said that he was more skilled than many higher educated people were. He said that he prayed regularly and could satisfy his wife sexually. Apart from this, he claimed that he could write letters and applications correctly, which many higher educated people could not do as correctly as he could. Thus, he saw himself as successful to some degree:

I say prayers five times a day. Muslims have to practise it. I try to do as much as I can … I discussed it [about sexual performance] with my wife. Have I been

able to satisfy you? She says that I’m all right, good enough. Initially there was … you know, I was a bit afraid.

As with the older social generation men, sexual prowess as demonstrated within marriage was a commonly cited key aspect of heterosexual masculinity. In the accounts they provided, middle social generation men tended to view the ability to satisfy their wives as a signifier of success: “Men’s main thing ... problem is ... jauno [sexual]. A man is not a real man if he doesn’t have sex power” (Dulal, 46 years, office assistant).

Other men expressed similar views when it came to the framing of masculinities. For example, Shahit said he would not “write the names of sexually impotent men in the book of man”. By this, he meant that sexually impotent men were not “real” men. In his view, if a man ejaculates before his wife is fully satisfied, he cannot be called a sottikarer purush (real man). There was, however, a critical relationship between their lower position in the work hierarchy and their capacity to enact this form of masculinity; interviewees described how their low income, work-related stress and the inability to eat a balanced diet affected their sexual prowess. For example, Mazid explained that he had encountered sexual health problems, such as not being able to penetrate for a long time, and therefore felt that he was not a real man. For Mazid, this feeling of being less of a man was exacerbated by his low income and his employment in low-paid informal sector economic activities:

Indeed I’m now not a real man. First, my wife complained against me once. She asked me to be with her for more time [during sex] ... [And the second wife] hasn’t been finding enough moja (sexual pleasure) for the last two years. She’s now saying, “Be with me for a longer time”. But I couldn’t give her this [moja]. From this point of view, I’ve totally failed. Another failure is that I’m not being able to give my child and wife clothes properly... I’m from all sides nobody. I’m not a real man if one looks at my economic situation, my work and my wife’s demand. I’m not a real man from all these perspectives. I can say I’m not a full man.

In the above quotation, Mazid positioned himself in a hierarchy of masculinities in Bangladesh. Having low income, having a less prestigious manual job and experiencing pre-mature ejaculation meant that he felt like a “nobody”. In other words, Mazid felt that he could not measure up well to the demands of hegemonic masculinity and he expressed deep frustration and dissatisfaction with life during the interview.

Men’s narratives indicated that they came to know themselves as sexually capable, and therefore, as “real” men after being endorsed as such by others. This foregrounds how notions of masculinity are shaped through social interaction. For example, prior to his marriage, Islam (35 years, office assistant) said that he had been unsure about his ability to korte para (have sex), and at the time of his marriage, he had been anxious about it, because he had never engaged in sexual relations and therefore had never put his capability to test. There were at least two signs, Islam stated, through which he had come to view himself as “man enough” (Seidler, 1997). First, he had asked his wife about his sexual performance, and he claimed his wife had assured him that he was sexually capable. Secondly, Islam said that his wife had conceived within the first month of them having sex together. Clearly, masculinities are not inherent traits; rather, it is through performative actions that men such as Islam come to understand and constitute themselves as men (Butler, 1990).

Notably, men in this middle social generation made no reference to the number of sexual partners as signifiers of sexual success, perhaps because pre-marital and extra- marital sex were viewed as immoral, and as “bad”. Instead, overall, their notions of masculinity remained firmly rooted in Bangladeshi cultural and Islamic norms that prohibit pre-marital and extra-marital sexual relations. Nonetheless, a small number of men reported having diverged from this masculine ideal by engaging in same-sex practices before marriage and paying for sex before and after they got married. These forms of non-hegemonic masculinity (i.e., sex outside marriage) may be linked to increasing urbanisation, strong homosocial bonds, gender segregation and the hierarchical gender order that characterises most South Asian societies, including Bangladesh. While urbanisation and sex-selective migration in a system of gender inequality has created demand for paid sex in urban areas, gender segregation from childhood means that even heterosexually attracted men may engage in sex with male dosto (friends) before marriage.

Nevertheless, middle social generation participants expressed homophobic attitudes towards somokamita or homosexuality. This homophobia signals the presence of deeply held heteronormative assumptions in Bangladeshi society. Many of the views expressed appeared to be based on a level of ignorance. Nazrul (40 years), for example, who taught Islamic history and culture at a college, had little idea about same-sex sexual

80 practices, which prompted him to ask me about the difference between English terms such as “gay” and “lesbian”. He believed that same-sex sexual relations or same-sex attraction were “artificial” or “unnatural”. Men’s narratives clearly suggested that religion and heteronormative cultural beliefs had shaped their attitudes towards same- sex relations. Nazrul believed they were haram (forbidden) and “acts against nature”. He said:

My religion doesn’t support this. Men having sexual relations with men … I don’t like this from both my religious and personal moral perspectives. If any action is taken against nature, nature will take revenge there. I haven’t seen this among animals; like a male dog doesn’t do it [sex] with another male dog. I’ll say that’s an act against nature. This is prohibited in religion. It’s said that it’s haram [forbidden in Islam]. I can’t support this.

It is interesting to note that, despite efforts to change both the Bangladeshi and, particularly, Indian Penal Codes, they continue to define certain sexual acts as acts against the order of nature. Nazrul echoed the legal-political and religious discourses about same-sex relations that have been in circulation since the British colonial era and within Islamic traditions. These notions of “abnormality” were reiterated in another interview with Zeshan (51 years, college teacher) when he also said that homosexuality was “artificial”.

Middle social generation men’s narratives highlighted the importance of strong homosocial bonds among men, bonds that are common in many South Asian societies where same-sex bed sharing and same-sex adda (congregating and chatting) are commonplace. While men’s friendships with women are often seen as a sign of weakness, heterosexuality is constructed as the dominant form of masculinity. Although men of this generation did not see same-sex-attracted men as sottikarer purush, several heterosexually married men reported sexual activity with their male dosto (friends) before marriage. Their accounts of these pre-marital same-sex sexual encounters are described in the next chapter.

Findings suggest that men of this social generation tended not to enact violent masculinity perhaps because of their lower socio-economic status. Participants’ narratives suggested that, for some men at least, the enactment of relatively non- confrontational forms of masculinity (in the public sphere at least) was linked to their marginal social location. They did not engage in confrontation or violence because they

81 lacked the social, economic and legal power to deal with the possible repercussions. Mazid, for example, who worked in a garment factory, said that he had not taken part in a workers’ protest at his workplace, because he feared that he would have been laid off. Had he lost his job, he would no longer have been able to provide for his wife and children. Thus men may choose to enact a particular form of masculinity from a number of options available to them, depending on what is at stake.

Nevertheless, some forms of violence were seen as “safer” than others, hinting at the way certain expressions of aggressive masculinity, especially when they did not threaten economic interests, may be culturally sanctioned. For example, Dulal reported that he along with some male friends had once beaten up a married man who they claimed had had sex with boys. This kind of violence against same-sex-attracted men by some men of this middle social generation indicates the dominance of homophobia, heterosexual masculinity and of marriage in Bangladeshi society.

In brief, narratives of middle social generation men show both similarities and differences in notions of manhood, compared to their older counterparts. While hard work, being a good Muslim, being a provider, homophobia, and sexual prowess remain as important elements of masculinity, in the changed work environment in the context of urbanisation, middle social generation men also displayed greater awareness of social inequality and the hierarchical nature of hegemonic masculinity. In the context of poverty, social inequality, exploitation of cheap labour in poor countries such as Bangladesh, they perceived themselves as not being able to live up to hegemonic masculinity embodied in being a bhadrolok or a gentleman (i.e., a highly educated white-collar professional).

Younger social generation men’s masculinities

In contrast to their older counterparts, younger social generation men displayed greater awareness of themselves as gendered beings. Given their access to higher education and technologies, such the Internet, as well as perhaps the nature of the sample recruited mainly through further and higher education institutions, most men of this generation displayed an analytic and self-reflective ability, which enabled them to talk about gendered practices and the cultural production of gender identities.

Younger men used a variety of phrases to refer to their selves, unlike their older counterparts who generally saw themselves as purush (man) only. Some younger men saw themselves as purush (men), some thought of themselves as sottikarer purush (real men), while others viewed themselves as chele (boys), who aspired to become purush later. Two same-sex-attracted men saw themselves as kothi or gay, while another same- sex attracted man described himself simply as a manush (human being).

Regardless of who they were, men of this social generation tended to see independence, manly ways of acting, problem-solving skills, money and power, high status work, sexual prowess and physical strength as features that distinguished a sottikarer purush from a purush. For example, Foysal (25 years, university student) and Pial (23 years, university student) emphasised (using English) that a real man should have “manly attitudes” and “style” respectively.

The first thing that comes to my mind is that they’ve to be muscular. And they should have manly attitudes. That means you’ve to have responsibilities. Responsibilities like you’ve to take care of problems ... If you have a problem, you’ve to get rid of it. (Foysal) I mean a man’s personality, style, concepts, his [way of] walking − all these reflect whether a man is really a man. And the way he talks … Again, with regard to sexual matters, there’s something. A woman wants that a man can ... I mean a man can do that [sex] well. (Pial)

As is clear from the above accounts, some younger social generation men differentiated between a biological man and more social and cultural notions of manhood. By the term “manly attitudes”, Foysal meant courage and problem-solving capabilities. Russell (27 years, computer engineer) said that he had developed his ideas of masculinity by reading books and newspapers, and watching movies. His early role model had been James Bond, whom he described as a bicokkhon (intelligent) man. In the following quotation, he described characteristics of an ideal man: “They have to be bicokkhon, should have work skills … Independent … and should have attraction to the opposite sex. They should be capable of earning. They should be well-spoken. They should have a sense of humour”.

A real man, for Russell, should protest against injustice. In line with these ideals, he himself had got into fights with local hooligans who sexually harassed some of the female students from his own university. In many Bengali and Indian movies, protecting women’s honour is presented as an idealised form of masculine expression. By punishing the perpetrators of female sexual harassment, Russell had attempted to enact this form of masculinity.

A few men of this younger social generation still viewed themselves as chele (boys), because they were not yet married and had not started a family. Nor were they doing the work they wanted to do. Nurul (19 years), who worked as a security guard, still considered himself a chele and said he would only become a purush (man) after he had reached 30 years of age when he would get married and start a family. Rahul (22 years, university student) also considered himself a boy rather than a man. He was studying engineering at a university and, like many other younger men, aimed to travel overseas for further study. He indicated that he wished to settle in a rich or “developed” country, and suggested that he would view himself as a man only after he had accomplished these goals.

It is noticeable here that younger men generally described more diverse and different characteristics of an ideal man, unlike their older and middle counterparts, who drew on a more limited and traditional set of ideas. These varied notions of manhood reflect changing aspirations in a globalised knowledge-based social world where skills, attitudes, knowledge and hard work are deemed necessary for success in life. By contrast, older and middle generation men largely relied on physical strength, perhaps because they themselves were employed in low-skill occupations that required mainly manual labour.

As with their older generation counterparts, work was an important aspect of masculinity among younger generation men, but in quite a different way and with a wider horizon of ambitions and possibilities. Given their access to higher education, several men aspired to take up high-status white-collar jobs, such as being a doctor or an engineer, unlike their middle and older generation counterparts. They believed that working, earning money and thus being independent were important aspects of being a sottikarer purush (real men). Although men of this social generation did not object as

84 strongly as their older counterparts did to women’s paid work, very few could picture themselves being dependent on a woman’s income. This attitude suggests few significant generational differences in men’s notions of breadwinner ideology. Many men of this generation expressed masculine anxieties about whether they would really be able to become sottikarer purush, given economic instability and increased competition in the globalised economy. Being an “established” man (i.e., earning money and being able to independently support a family) in the near future was an important aspect of ideal manhood for some men of this social generation. Foysal’s romantic-sexual relationship with his girlfriend had broken up. He reasoned that it was because of his not being “established”. Moreover, the girl’s parents had been insisting on her getting married as early as possible, but with an “established” man:

It’s because she’s growing up. You know, in Bangladesh parents want their daughters to get married at an early age. When they’re above 20 [years], they’re ready for marriage. Her family also started doing this. So we felt that I’m not ... I haven’t established myself. There’s no way I can marry her right now. I can’t tell her parents to wait. Cause I don’t know what I’ll do. So even though we’re close, we aren’t with each other.

Foysal’s narratives indicated that young men like himself can feel vulnerable in situations in which they may not successfully measure up to certain forms of hegemonic masculinity.

Younger social generation men’s accounts further indicated that their notions of hegemonic masculinity were formed in the context of globalisation, new opportunities for international migration and access to education. For these men, studying university subjects such as engineering, medicine, business studies (such as getting an MBA) and settling abroad (in contrast to living and working in their home country) represented a more prestigious option than studying arts or language. Some younger social generation men aspired to adhere to what Connell (2005, 2011) called “international business masculinities”, which are emerging in the wake of global integration. Karim (21 years, university student), for example, hoped that he might work for a multinational corporation in the future, while Foysal, who was studying business at a university, wanted to be a successful businessman and earn a lot of money. Each of the other younger social generation men aimed to be successful in whatever occupations they thought they might choose in the future. The emphasis on personal choice in their

85 accounts signals the influence of neoliberal principles promoted through multiple institutional sites, such as the media, multinational corporations and governments.

As was the case with men of the other two social generations, heterosexuality and sexual prowess were central to masculinity for many younger generation men. To quote 27-year old Roshid, who worked as an electrician:

Suppose I’ve had sex with my wife. Suppose, I used to have sex for half an hour. Now I can do it for five minutes longer. My wife says, “I’m not being able to continue any more. Please get up ... leave me, I’m not being able to put up with it any more”. Then it feels like, yes, I’m a sottikarer purush [real man]. Older people used to say that if a man’s sexual power is six times, a woman’s sexuality is nine times as intense.

For Roshid, as for men of the middle social generation, being a sottikarer purush linked closely to the duration of the sexual act. Because women’s sexuality is culturally perceived as more “intense” than a man’s, satisfying a woman was deemed a challenging task, providing a test for one’s masculinity. Roshid elaborated:

This is what I have been hearing. Now I’ll have to defeat someone with nine times intensity with that of mine which is six times intense. [If I can do that] then obviously I’m a real man. If I can’t, if I’m done, but my wife’s isn’t done, or if I go to another woman. If I climb up like a hen and get down like a duck. If I can’t do it [sex], can I be considered a man?

It is noticeable how Roshid uses the imagery of the duck and the hen, which are traditionally seen as weaker animals. Like Roshid, Imran (20 years, university student) and Russell (27 years, computer engineer) also indicated that sexual strength was important to them. Some men engaged in traditional practices believed to assist in this respect. Russell, for instance, said that he had eaten honey and nuts to preserve or increase his sexual energy. Imran too knew about the importance of eating black cumin and honey to increase sexual prowess.

Some younger social generation men saw sexual prowess as an important dimension of masculinity. Others viewed sexual success as dependent on having a sexual partner. Foysal indicated that he felt distressed because of two break-ups. Unlike Foysal, Pial claimed that he was superior to his male friends because he had had sex with a higher number of women. He also said that he could pull any girl (in his words, ayotte niye asa) and could have casual sex with her, which many of his friends could not do. Thus

Pial, among others, perceived himself as more sexually successful than other men, suggestive of there being hierarchical masculinity within younger social generation men’s social networks.

Those who identified as heterosexual believed that a real man should be attracted to women only. Like their older and middle social generation counterparts, many men of the younger social generation expressed negative attitudes towards same-sex sexuality. Karim, for example, believed that a man should only be attracted to women: “An ideal man should have a strong mind as well as a body. He must also be sexually attracted to women. He must not be overly shy. And I don’t think of men who have sex with men as real men”.

Drawing on religious morality, Roshid (27 years, electrician) described same-sex relations as a kabirah gunah (a great sin). Russell, on the other hand, argued that a man who is desired by women represents an ideal man – an idea he had developed by watching action movies. In line with this idea, Pial boasted that he was “superior” to other men because of his supposedly extraordinary quality to “bring any woman under control”:

I talked to a girl last night too for the first time. I brought her under my control. If I ask her to come now, she’ll come. She’s not very good looking. Three boys propositioned her, but didn’t get her. I’ve lots of experiences in this regards. So I thought I’ll try. My goal is to be superior to everyone. If others fail, I try to do this myself. I think I’ve much better qualities than them.

I asked Pial more about his situation and his feeling of difference from his friends. In particular, I wanted to know if his attitudes had been influenced by Islam’s prohibition on pre-marital sex. He did not want to answer this question:

Let me request you ... Don’t ask any question regarding religion. I’m very scared of talking about religion. If I do something without knowing, it won’t be a sin. But if I do anything wrong knowing, it will be a sin. What I did, I did without knowing. I think Allah will forgive me. That’s why I try to know less, in case I commit any sin.

Younger men, caught between sexualised global popular culture, on the one hand, and conservative Islamic and Bangladeshi society on the other, often expressed ambivalence towards pre-marital sex. Russell, for instance, had a girlfriend with whom he had never engaged in sex. This was in contrast to his many friends who had done so:

I never thought that I’ll get physically involved [have sex]. Even [though] I’d a previous girlfriend. I’d a chance to have sex with her, but I didn’t. Then my norms were very strong. After that, I was really frustrated for the last one and a half years. At that time I needed a partner. Then I felt like the norms were not norms at all. It felt like the norms were a burden in a situation where everyone else had sex. All of them…. They thought I was different.

Unlike their heterosexual counterparts and all older men, the three younger generation same-sex-attracted men in the sample questioned traditional norms and heteronormative assumptions, indicating both generational similarities and dissimilarities in attitudes towards same-sex relations. Fahim (22 years, college student) and Helal (24 years, university student), who both identified as Muslim, believed that same-sex relationships could be congruent with Islam, raising important questions about the future status of claims to masculinity in Bangladeshi society. Since there are divergent interpretations of Islam in relation to somokamita [homosexuality], debates exist regarding this issue. In South Asian context, some Sufi Muslims had a history of having same-sex relations, while others see celibacy as a path to Allah or God (Sondy, 2014, p. 177). Some Bangladeshi social media users debated the issue of somokamita as the reports of the legalisation of same-sex marriage in the USA was published in Bangladeshi newspapers (Ebert, 2015). Helal’s and Fahim’s questioning was perhaps indicative of their greater exposure to other cultures made possible by access to newspapers, social media and higher education:

Yes, religion says that somokamita isn’t right, but I'm not sure for whom it isn’t right. Since childhood I’ve had this moho [desire] for men. As I’ve said earlier, when people are hungry, they run for food. When a child is hungry, he/she cries. It means he/she is calling. I’m not sure whether there’s any instruction in our religion regarding whether doing this [sex with men] is onnai [inappropriate] for people who have this mentality and feelings [of same-sex attraction]. What I think is that our religious leaders don’t know about these things properly. They perhaps don’t know what exactly two men want, what their desires are, what their feelings are. If they knew they could have given a full explanation of this. I don’t know much about it. Our religious leaders will be able to give an explanation. (Fahim)

Significantly, in the above account Fahim provides a different interpretation of Islam in relation to the acceptability of somokamita, questioning the rigid claim that homosexuality is by definition incompatible with Islam. These viewpoints are radically different from the belief, expressed by men from different social generations, that same- sex sexual relations are haram (forbidden in Islam).

Growing up as same-sex-attracted men in a heteronormative society, experiencing abuse and having few local opportunities to understand better their sexuality, same-sex- attracted men in Bangladesh have actively sought out information from the media. By doing so, they have located information about debates over same-sex marriage and learnt about the gay rights movements in Western countries. Fahim’s explanation of Islam in relation to same-sex sexuality was perhaps enabled by his access to higher education as well as by technologies such as the Internet.

There were also examples among these same-sex attracted men of more diverse, non- traditional gender identities taking shape in the context of globalisation, urbanisation and technological advancement. These developments have opened up new avenues for sexual opportunities and they have also shaped new and non-normative gender identities. Both Helal and Fahim recognised that although many members of Bangladeshi society might not see them as purush, they were purush, but their “sexual orientation” was simply different and their “feelings” were more like a woman’s. Being a male-bodied same-sex-attracted person, Helal said that he had led a “life of acting”, and that he often needed to act in either masculine or feminine ways depending on the social context:

Physically I'm a boy. But my feelings, my sexual orientation and thinking are like a woman’s. But this varies from one situation to another ... Yes, it depends on time and situation. There's no change in [my] sexual behaviours. But the differences are in my [other types of social] behaviours. When I mix with the people of the community [networks of same-sex-attracted men], I'm acting in a feminine way. And while I'm with my normal friends, I'm chatting with them about my female friends, I act like a man …These days I do this less and I try to avoid it. I don't feel like doing it, but I'm being forced to do so.

Helal’s quote indicates how enactments of gender can be situational and how male- bodied same-sex-attracted persons may act in both masculine and feminine ways. He explained that he could “do” his gender the way he wanted to when he was among same-sex-attracted persons, but in front of his straight friends, Helal had to “act” according to heteronormative standards. But he tried to avoid leading a “life of acting”, as he was increasingly coming to terms with his gender identity.

These findings indicate that exposure to aspects of Western culture and education can play a key role in transforming a male-bodied same-sex-attracted person’s notions of gender. One same-sex-attracted person, Nahian (27 years, researcher), educated in the UK and the USA, said (partly in Bengali and partly in English) that he did not believe in gender constructs:

I’ve read Butler and ... things like that. So how can I believe in gender construction? These are nothing. Rubbish … I see myself as a manush [human being]. I see myself as [Nahian]. I’m not bothered whether I’m seen as masculine or feminine.

While religion played an important role in the production of older social generation masculinities, it tended to be less significant in the making of younger generation masculinities. Nevertheless, having to deal with religious norms in an increasingly urban, global environment meant that many younger social generation men were often ambivalent in terms of their attitudes and enactments of masculinity. Nahian was an exception who also revealed that he had given up religion after moving to the UK and the USA, where he found himself mixing with many non-religious people.

Several explanations can be offered for the formation of these non-normative gender identities. Growing up as same-sex-attracted persons in a strongly heteronormative social and cultural context, Helal and Fahim reported that they had experienced verbal abuse for acting in supposedly “feminine” ways since childhood. When younger, they had not had a readily accessible language in which to talk about their sexual subjectivity. Each reported having felt “all alone on this whole planet.” Terms like MSM (men who have sex with men), gay and kothi offered them an opportunity to articulate their non-normative gender and sexual identities. At the time of interview, both Helal and Fahim worked for a leading Bangladeshi sexual health organisation and both were studying at university. Their use of terminology was interesting as they used both local and Western terms to refer to their gender identities. First, they saw themselves as MSM because non-governmental organisations in Bangladesh tend to use the term MSM to refer to men who have sex with men. Secondly, these men stated that they had come to know about the Western term “gay” through newspapers and social media, suggesting the influences of global media on the construction of local gender categories. Both participants suggested that the term kothi came from the hijra community to refer to men who they described as “bottoms” or “takers”. They preferred

90 terms such as MSM and gay to the phrase kothi, although they did not have any objections to using the phrase kothi to refer to certain aspects of their sexual and gender identities. As NGO workers and as individuals who had experienced verbal abuse and homophobia, it was the rights of same-sex-attracted individuals that they were most concerned with, not the suitability of the terms used to describe them. Overall, their use of local and Western terminologies reflects the impacts of global media, English education and Westernisation of local gender categories through donor-funded NGOs in countries such as Bangladesh.

The younger social generation men’s accounts suggest that openness to the global media, access to higher education, the possession of advanced English language skills and so on, may be some of the reasons why members of this social generation expressed more diverse masculinities than their older counterparts. Same-sex sexual desires and non-normative masculinities are not new phenomena in Bangladesh, but may have found more open expression in the urbanised, globalised environment. Moreover, ongoing cultural globalisation, with its widening of the discursive field, has also diversified the identities that younger generation men can adopt and enact. It is noticeable, for example, that previous generations did not use the word “gay” – which is consistent with previous researchers’ argument that there have until recently been no strongly defined sexuality-based identities but only sexual practices, including same-sex practices, in parts of South Asia (Khan, 1994).

Regardless of their sexuality, younger generation men’s accounts reveal the influence of Westernisation and city life on how they enacted their masculinity. Most of these young men stated that they were born in, or had grown up in the city, which may have offered them opportunities for more diverse lifestyles than their older and middle social generation counterparts. For example, some participants reported having engaged in partying, going out drinking, using drugs, and getting into fights. Here, some similarities are noticeable between the forms of masculinity enacted by younger men in Bangladesh and those in more Western contexts. Men from the two older social generations did not make much reference to having been involved in such activities, which older generation men in particular saw as anti-social and anti-religious.

However, there were variations within the younger generation of men. Babor’s (22, van driver) and Nurul’s stories were somewhat different from those of other younger generation men. Because of their lower social and economic background, they enacted a form of masculinity that was perhaps in some ways similar to those of older and middle social generation men in this study. Religiosity also appeared to be more common among lower class men and men of older social generations in this study and may be linked to their greater social, economic and political vulnerability. For example, Nurul aspired to adhere to Islamic, heterosexual masculinities, as older social generation men did. He reported that he did not engage in or desire to have pre-marital sex, suggesting continuity with older forms of masculinity. Nurul said:

I’m a Muslim … I perform namaz and do foriyad [prayers] to Allah so that today I’m at this position [security guard at a college] and so that I get to the next higher position [in terms of employment] tomorrow [meaning in future]. If Allah is satisfied with me, I can be at any position. Both hayat and mouth [life and death] are in the hands of Allah.

It is noticeable that some variations in the enactment of masculinity within and across social generations (such as those between Roshid and Babor on the one hand, and the rest of the men from this generation) were perhaps influenced more by socio-economic status than by social generation. Besides this, some inter-generational differences in masculinities (such as those between the youngest and the oldest generation men) may have been produced by both class and social generational membership. Importantly, membership of a social generation intersects with class and socio-economic status, which together co-produce differences or similarities in the enactment of masculinity.

Conclusion

Based on the men’s accounts, in this chapter I have highlighted both generational continuities and discontinuities in the men’s ideas of masculinity in Bangladesh. Findings indicate the importance of religion, political and historical circumstances such as war, and economic and cultural change in the production and enactment of masculinities in the Bangladeshi context. Being a “good” married Muslim man who provides for his family was one of the most important aspects of masculinity among older and middle social generation men. In contrast, members of the younger social generation did not wish to adhere strongly to this type of masculinity, with religion

92 seemingly playing a less overt and potentially less important role in the production of younger generation masculinities, in this study sample at least.

While almost all older men and most middle social generation men aspired to adhere to multiple aspects of Islamic masculinity through their engagement in prayers, fasting, and religious tours, younger men generally did not report such passionate forms of religious engagement. In contrast, a few younger social generation men’s engagement in partying, cross-sex mixing, pre-marital sex, drinking, smoking and fighting may in some ways be linked to the gradual Westernisation of the upper (and middle) classes in developing countries such as Bangladesh. This is because of the younger men’s exposure to modern Western education, their use of global media and new social technologies, and the greater emphasis placed on secular values in the post- independence period.

Generational differences and similarities were also noticeable in men’s notions of gender and of sexuality. Men from all generations emphasised sexual prowess as a dominant aspect of masculinity. However, while members of the first two social generations believed sexual relations should only take place within marriage, younger generation men were either more ambivalent or experienced difficulty articulating their perspectives on pre-marital sex, given that they still had to deal with the cultural and religious norms of their parents and other members of the older generations.

The findings indicate few or no significant social generational differences with regard the perceived importance of men’s work and provider roles as aspects of masculinity. Notions of men’s responsibility to work, earn, provide for family and thus achieve power and independence were common across the three social generations, even though they manifested themselves in different ways given the different economic and educational opportunities available to the three social generations. These continuities and discontinuities suggest that certain aspects of patriarchal masculinity and gender ideology prevail, even though Bangladeshi society is undergoing considerable social, cultural and economic change. It points to both continuity and mutability in the manner in which masculinity, and ultimately masculine “selves”, are constructed and performed by men of different social generations.

Chapter 5: Generational sexualities: patterns in men’s sexual practices

Introduction

In order to examine the implications of men’s enactment of masculinities for their sexual health, it is important to develop a better understanding of their sexual practices. This chapter reports on sexual practices of men in each of the three social generations, highlighting both similarities and differences. The findings suggest that men’s sexual practices are shaped by a myriad of social, religious, cultural and economic forces.

Certain patterns emerged from the men’s narratives about their sexual practices. First, older social generation men’s attempts to adhere to the dominant norms of Islamic masculinity and Bangladeshi traditional cultural values relating to sex were reflected in the descriptions they gave of their sexual practices. In line with these norms, most older social generation men reported remaining in monogamous sexual relations and not engaging in pre-marital or extra-marital sex.

Secondly, as societal values have changed to some extent in the context of rural-urban migration, urbanisation and economic globalisation, middle generation men reported having engaged in more diverse sexual practices, with a small number of them recounting pre-marital sex, extra-marital sex, and sex with other men and paying for sex. However, as with their older counterparts, a good number of middle generation men also claimed not to have engaged in pre-marital or extra-marital sex.

Finally, the most important aspect of younger social generation men’s sexual practices was their engagement in pre-marital sex, reflecting significant differences in cultural norms relating to pre-marital sex. However, a related aspect of sexual practices among younger social generation men was the irregularity and secrecy of sex, itself likely to be the result of wider social sanctions against pre-marital sex. The responses provided by each of the three social generations of men are examined in more detail below.

Older social generation men’s sexual practices

The narratives of older social generation men highlighted the importance of Islamic beliefs in the making of masculinities, which in turn shaped participants’ sexual practices. In line with their Islamic beliefs, men from this social generation generally emphasised that pre-marital and extra-marital sex was against Islam and all men, except two, claimed that they had always refrained from pre-marital or extra-marital sexual relations and that they had been monogamous throughout their lives, thus enacting an idealised form of Muslim masculinity. Leading a life according to the Islamic codes of conduct described in the Quran or the Hadith (instructions by the Prophet Mohammad) can be described, in brief, as an ideal form of Muslim masculinity, although men’s religious practices might sometimes deviate from this ideal. For instance, five older social generation men, Adil (75), Bazlul (73), Mozammel (72), Halim (70) and Amir (56), mentioned that they had only ever had one monogamous relationship. Akkas, who was a cook and who reported being more than 70 years old, said that he had married a second time after the death of his first wife in 1974. These older men all claimed to never having had any sexual relationship outside marriage. Like other older social generation men, Akkas emphasised that he had not had any pre-marital or extra-marital sex: No, no. I haven’t had that sort of nesha [addiction]. I mean even if I’d had [that sort of addiction], I hadn’t had the courage to do it. Everyone has some attraction towards women before marriage. I haven’t had any kharap somporko14 with anyone. I’m telling you the truth.

By using the term nesha (or addiction), Akkas was referring to pre-marital or extra- marital sex. Such sex, he argued, was kharap somporko or a “bad relationship”, reflecting his religious-moral values concerning sex. According to the particular form of Islamic masculinity that these men strove to embody, sex outside of marriage was, as one man put it, haram (that is, un-Islamic or forbidden in Islam).

Another older social generation man, Mozammel, also articulated an idealised pattern of Muslim masculinity. He mentioned that he had never engaged in any pre-marital or

14 The term kharap somporko literally means bad relationships. It usually refers to the break-up of social relationships or day-to-day social relationships marked by personal bickering, tensions, complications, animosity, and conflict. Here, however, Akkas uses the term kharap somporko to express his moral and religious views relating to sexual and/or romantic relationships outside marriage.

95 extra-marital sex, although he said that in his youth women in his village used to mix with him. Like other men of his social generation, Mozammel had grown up in a predominantly Muslim village where cross-sex mixing was seen largely as inappropriate. He reported that he had had female friends in his village, including married ones, a quite unusual scenario in the sex-segregated rural Bangladesh, especially at that time. Mozammel claimed that villagers knew him as a good man, unlike other men of his generation, because they believed he would never do any kharap kaaj15 with the women he had an opportunity to mix with. By portraying himself as a “good man” in relation to other men, Mozammel may have used this story to emphasise how well he lived up to the idealised form of Muslim masculinity. When I probed further regarding any involvement in extra-marital or pre-marital sexual relationships, Mozammel reiterated:

As I’ve told you, women, even married women, used to lie on the bed with me in front of their husbands. But nothing had happened indeed. They used to trust me. Up to this moment, I haven’t done any dui numberi kaaj16, and there’s no possibility of this happening in life, because I’m going to die [because of old age].

In sex-segregated rural Bangladeshi settings, it was rare for women to lie on an unrelated man’s bed, but Mozammel used this expression to indicate how closely he had mixed with women in his village, yet he had not had sex with any woman.

Overall, men’s accounts suggested that their social and sexual lives were largely organised around marriage, a powerful social institution in Bangladesh. These older men said that their marriages had been arranged mainly by their fathers, but sometimes jointly with other relatives and match-makers. Several older social generation men added that they first met their wives at their weddings. With the exception of only two men, it was within these heterosexual marriages that men reported that they lived their sexual lives. Importantly, men were not aware of terms such as “heterosexual” and did not describe themselves as such, even though they had been in monogamous

15 Kharap kaaj literally means bad work. However, in this case, the phrase kharap kaaj was used to indicate any act that may be viewed as violating normative standards of sexuality. 16Dui numberi is often used as an adjective in colloquial Bengali language, to signify goods that are not pure or adulterated. Somewhat similar to kharap kaaj, by using the term dui numberi kaaj, Mozammel may be highlighting cultural notions of purity and pollution relating to sexual practices. As noted above, sex outside marriage is generally viewed as kharap kaaj and socially unacceptable.

96 heterosexual marital relationships throughout their lives, which points to the normativity of heterosexuality in this cultural setting.

In their accounts, men of this social generation tended to valorise heterosexual masculinity as enacted in the context of marriage, describing their sexual lives as having been largely satisfactory and active when they were younger, especially immediately after marriage. They reasoned that this was because they thought they had been able to sexually satisfy their wives and had had sex for longer and more frequently than in their older age. Mozammed, for example, proudly mentioned that he had had sex six times “correctly” on his wedding night, supposedly the first time he had ever had sex:

We’re young. And my wife hadn’t had sex with any man before [marriage]. [So] initially she’d been reluctant, but after [me] trying a lot, she’d done [had agreed to have sex]. This was how it all started. My first attempt had gone in vain. I’d done it [sex] six times correctly. After this, I’d been doing it both in the day and at night.

Mozammel stated that his “first attempt had gone in vain” on the same night because his “body was so gorom [sexually aroused] that the jinish [semen] came out too quickly.” In this way, men reasoned that it was through their sexual capability that they came to perceive themselves as sottikarer purush17 (real men) when they were younger.

Men of this social generation reported that the frequency of sex significantly decreased with age, feeling it natural that they should lose their sexual prowess, as they gradually grew older. For this reason, some men expressed the view that they were no longer sottikarer purush at older age. In this way, men’s narratives highlighted the temporality and provisionality of notions of masculinity, as they can clearly change with age.

As men reported a decrease in their sexual prowess with age, they no longer had the opportunity to express heterosexual masculinity by demonstrating sexual capability. Some widowed men reported having no sexual partners at the time of interview. They said that they had not considered re-marrying since they had become widowed. For example, Kashem (75) did not marry after his wife had died of a disease in 1971, during the Liberation War. He attributed this to his inability to provide maintenance: “During

17Men mentioned different types of criterion for being a sottikarer purush. However, in this context, they perceived themselves as sottikarer purush if they saw themselves as sexually capable, which was often demonstrated through sexual prowess. These are discussed in more detail in Chapter 4.

97 the time of songram [the 1971 War], suppose, today the War started and tomorrow my poribar [wife] died … Why would I marry? I can hardly make my own living. I can’t have the luxury of a marriage.”

Kashem indicated that he had not been able to make enough money to make ends meet, and so a second marriage would have been a “luxury” for him in a social context where men are expected to be breadwinners. Having no income of his own, he had been living with his adult son, who was a van driver, in Gazipur city.

Like Kashem, another older man, Adil (75), also did not think of re-marrying after his wife passed away about 13 years ago when he was still living in his village. Two years later, he moved to Gazipur and became a member of the Tabligh Jamat. Thus, older men became invested in alternative, more traditional forms of masculinity instead of the masculinity implied by the display of heterosexual sexual prowess. One such alternative form of masculinity could be cultivated through a deeper investment in Islamic practice, as was the case for Adil, who after being widowed became more seriously involved in the work of the Tabligh Jamat and spent most of his times in the mosque.

As noted above, two men did describe having had sex outside marriage. The individuals concerned, Mobin and Forkan, belonged to the older social generation, but their narratives offered a somewhat different reading of the performative aspects of Islamic masculinity. Although both were married and identified as Muslim, they reported having paid for sex with women. Forkan, a rickshaw puller, stated that he had paid for sex many times. Since pre-marital and extra-marital sex was described as haram (forbidden) in Islam, Forkan justified sex outside marriage by saying that his wife was unable to have sex with him. He attributed this to his wife being too old and sick. Describing her as too durbal (weak) to have sex, Forkan stated that he did not want to force her to do so. He also made reference to his male friends who, he indicated, had encouraged him to have sex with other women. Forkan explained:

When my wife couldn’t do [have sex], I’ll not tell you lies … like friends used to come and say, “Come on, let’s go there.” Those who had been concerned with honour, they’d done it [had sex] going far away [from home or locality]. And those who hadn’t had this issue, they’d done it near [the town]. This was like this. Whatever happened, it’s good to keep secret.

Forkan’s account suggested that, because he had honour as a married man with adult children, he had gone far away from home and locality to have paid for sex with women. Thus, Forkan’s enactment of masculinity in this case deviated from the idealised form of Islamic masculinity in the sense that he had had sex with women other than his wife. But Forkan’s case further suggests that some men may renegotiate this ideal depending on their circumstances.

In sum, men of this social generation could live up to the ideal model of Islamic masculinity, especially in their younger age. However, their enactment of this form of masculinity was not uniform, with two men reporting some departure from this ideal. Moreover, in their old age, when they could no longer fulfill the requirements of masculinity embodied in sexual prowess, they tended to take up alternative forms of masculinity. This hints at the provisionality and temporality of masculinity. Men’s enactments of this form of Islamic masculinity may have considerable implications for their sexual practice and sexual health risks. One the one hand, adherence of Islamic masculinity may limit pre-marital sexual expression; on the other hand, sexual health risk linked to unsafe sex with multiple partners is greatly reduced.

Middle social generation men’s sexual practices

Middle generation men’s interview narratives indicated both the continuities and discontinuities of more traditional Islamic forms of masculinity. While some men claimed not to have had pre-marital or extra-marital sex in line with dominant Islamic and Bangladeshi cultural values, others mentioned that they had engaged in pre-marital and extra-marital sex with women in exchange for money or at times with other men, or, when they were younger, with other boys. Patterns in the middle generation men’s sexual practices are discussed below.

First, findings suggest that men’s first and early sexual practices varied. The men belonging to this social generation described a range of first sexual experiences, including feeling shihoron (sexually aroused), having swapnodosh or wet dreams, having sex with other boys and paid sex with women. For example, Islam (35 years, office assistant) mentioned that he had felt shihoron in his body during his early teenage years. Dulal (46 years, office assistant) also reported feeling the same. Although they

99 knew some of their friends at the time were having penetrative sex before marriage, they themselves claimed not to have done this, mainly for fear of social repercussions based on moral-religious values prohibiting pre-marital sex in Bangladeshi society.

Men belonging to this social generation indicated that their sexual awakening was largely one of unfulfilled sexual urges, having wet dreams, and experiencing sexual arousal and erections. All these happened in a context in which sex was (and still is) a taboo subject, and where there was little opportunity for sexuality education. As Nazrul’s (40 years, college teacher) quotation below indicates, friends might talk among themselves, but they could make little or no sense of why these experiences were happening.

During the eighth or ninth grade, I’d felt sexual urges. I would wonder about why this was happening. We’d discuss between our male friends regarding these things, but not with girls … It would be regarding wet dreams and erections and so on. [Conversations between friends went on like the following] “Dosto [friend], this has happened today. I was sleeping and my ‘that one’ [penis] stood up [got erection].” We said this to a few close friends. They’d say, “I’m also experiencing the same.”

Having no adults or professionals to discuss sexual health issues with, Nazrul could talk about these issues only with his male friends who knew as little as he did. Moreover, Khairul’s (34 years, street vendor) quotation below indicates that he had aspired to get married in the future to have an opportunity to have sex more regularly than the several episodes of sex with a boy and a woman that had happened before marriage: “Before marriage I used to think, I’ll marry a woman. Allah has given such a good system. I used to think, after marriage I won’t do any other things but sleep on [the] bed [with my wife].”

Several middle social generation men reported that their first penetrative sexual experiences had been with other boys. Khairul, for example, a married man with children, was a vendor who sold tea, biscuits and snacks in Dhaka and Gazipur. Earlier, he had worked in a garment factory, but had left that job to work independently. He said that his first sexual encounters had been with his male friend when he was about 13 or 14 years old:

100

When we’re younger; a boy was saying, “Dosto, tui amare putki mar, ami tuke putki mari” [Friend, insert into my anus and I’ll then insert into yours]. Then I said, “Ok let’s do it.” “Pore se amake putki mare are ami take putki mari [Then I inserted into his anus and he inserted into that of mine]. That’s the situation. It’s between boys. Another day he said, “Come on, dosto [friend], let’s get a maiyya [woman].” We’d done this [had had sex] together [with the women] and [earlier] I said, “Where are you going to get maiyya [women] from?” He said, “Ok let’s go and get one, dosto.” I asked, “Where are you going to get money from?” He said, “Today I’ll sell mangoes from the trees.”

Another early incident of sex with a boy was, as Khairul described it, a “bad story”, which was why he was initially reluctant to tell it. He did not explain why it was a “bad story.” It seems that later on he realised that sex between men went against the dominant heteronormative values of his social settings. For Khairul, the incident of having sex with a boy was an important event he would remember for the rest of his life: “Later he got married, I too got married. He has a songsar [family life] now and I too have one. He’ll remember this history throughout his life. I’ll remember this even if he forgets.”

Khairul’s story describes a typical sexual trajectory for many middle generation men in the Bangladeshi context, starting with sex with other young men, then paid sex with women (including female sex workers), and then finally after marriage sex with their wives. Researchers have claimed that in strongly heteronormative, homosocial South Asian settings, sex between boys/men happen secretly and at early stages of their lives (Khan, 1997; Boyce & Khanna, 2011). As South Asian countries, including Bangladesh, are largely sex-segregated, it is not uncommon that some boys’ first sexual experiences are with other boys or men. This can be attributed to prohibitions on cross- sex mixing, strong homosocial bonds formed since early childhood, same-sex bed sharing and, importantly, heteronormativity. Despite social sanctions on pre-marital sex, because of heteronormative assumptions that sex occurs between a man and a woman only, sex between boys/men often go unnoticed. Other later patterns of sexual trajectory are described below.

Secondly, middle social generation men’s accounts suggested that notions of purity and pollution in romantic/sexual relationships were central to understanding their sexual practices. These were most clearly presented in discussions about prem or pre-marital cross-sex romantic relationships. Prem has been a key theme in Bengali literature and

101 cinema, in which conflicts often arise from prem between a lower class man and an upper class woman, and vice versa. In this study, and for this social generation of men, all men who had had prem claimed that their prem relationships were pobitro (“pure”, in the form of prem not involving sex).

Some, such as Zeshan, Nazrul, Salam and Dulal, claimed that they had not had sex with their premika (girlfriends) to protect the purity of the relationship. Zeshan married his wife (a college teacher) after having prem for almost six years when they were university students, but he mentioned that “the relationship had always been pobitro and sshocchho [pure and transparent]” in the sense that sex had not jeopardised the pobitrota (purity) of the romantic relationship.

In a similar vein, and contrary to the popular belief that men are always ready for sex (Webb, 1998, p. 34), Dulal said that he had not had sex with his premika despite having had the opportunity. Dulal had had a prem relationship with his girlfriend since he was a high school student in his village. Because of the social sanctions on and social repercussions of having pre-marital sex, however, he was too scared to have sex with her, even when she made sexual advances: “I’d feelings, but I couldn’t do anything ... I’d fear and the girl had problems. One day she grabbed me to have sex, but I didn’t do anything.”

Later Dulal migrated to the city. But in his village, as in any typical Bangladeshi village, samaj (literally meaning society, but more broadly comprising a number of households within a village that strongly regulate the social, moral and religious lives of their members) played a strong, regulative role in shaping sexual practices, punishing men and women found to be involved in pre-marital and extra-marital sex by informal village courts. By “the girl had problem”, Dulal implied that she wanted sex which she was not supposed to do, given the social context. Her attempts to initiate sex, for Dulal, also went against gender norms in the village setting where women are expected to play a more passive role.

Thirdly, as was the case with older social generation men, not having pre-marital or extra-marital sex was a common theme in most middle generation men’s accounts. Unlike their younger counterparts, Dulal, Zeshan, Islam, Shahit (35, rickshaw puller)

102 and Alim (35, van driver), for instance, claimed that they had not engaged in any pre- marital or extra-marital sex. Islam mentioned that his first melamesha (mixing, i.e., sex) had happened with his wife soon after he got married at the age of about 33 years. In Islam’s words, sex before/outside marriage was not appropriate: “I hadn’t had any oboidho melamesha [illegitimate sex] with any legitimate or illegitimate women before marriage.”

Islam’s statement above reflected his moral and religious views regarding sex. By “legitimate women”, he meant sexual relationship with a wife; by contrast, by “illegitimate women”, he meant sex with any woman other than a wife, especially women his friends had had sex with for money. He added that he had wanted to get married about nine years earlier than he actually did. He said that he practised Islamic rituals by performing namaz as much as he could. Therefore, even though his male friends often encouraged him before his marriage to go to have paid sex with women, he refused to do so:

“They’re naughty. They used to say, ‘You’re not like us [sexually experienced]’. They used to say, ‘Let’s go that way [places where women are available to have paid sex with]’. What I thought ... I’ll do with my wife only. It’s not that I won’t do it. But I’ll do it after marriage.”

Similarly, Shahit said that sex for him had not taken place before marriage and he hoped that sex outside marriage would not happen in the future. Shahit cited concerns about semen-loss as a reason for not engaging in pre-marital sex, and religious and moral reasons for not having extra-marital sex.

Only my wife had me. Even my premika never had me. When I was younger, my grandfather said, “Do not write with your own ink on someone else’s notebook. If the ink of a pen is used up, it can be refilled, but if a man’s ink is wasted, it cannot be refilled.” I still remember his advice. I think it’s very true … I feel all women have the same [body] parts. So my wife is sufficient for me. It’s a sin [to have sex outside marriage and doing so] also requires money sometimes. Allah won’t forgive this [sin committed by having sex outside/before marriage].

Most men of this social generation mentioned that sex within marriage was frequent and satisfactory. Since sexual potency was central to dominant understandings of masculinity, most middle generation men reported being sottikarer purush or “real men” so far as sexual performance was concerned. Some, however, mentioned the need

103 to balance between “too much” sex and “too little” sex. On the one hand, no sex or not enough sex could jeopardise a man’s sense of manhood. On the other hand, most men believed that potency would be lost through “too much” sex because semen would be wasted. Thus, they aimed for a balancing act with respect to the frequency of sex within marriage in order to preserve a sense of manhood and masculinity.

A few participants of this social generation reported feeling they were not sottikarer purush in the sexual sense. Zeshan and Khairul, for example, said that marital sex had become boring for them, and Dulal and Mazid had experienced sexual health problems such as premature ejaculation and erection problems.

In contrast to the dominant pattern for men of this social generation described above, a small number of men of this middle social generation, such as Salim, reported having had extra-marital and non-marital sex. They characterised the act of having sex outside or before marriage as baire jawa, which can be translated as going away from home or one’s own locality. Some of these middle social generation men reported having engaged in paid sex with women whom they characterised as kharap meye (bad women) or baje meye (evil women). Their accounts suggested that kharap meye or sometimes just mohila, meye or maiyya (all terms meaning women) could be available in kharap jaiga or “those kind of places”, most usually hotels, boarding houses, parks, rented houses, para (brothels), and places on the roadside where sex happens in exchange for money.

Among men of this generation, engagement in paid sex was largely contextual, as Salim’s case indicates. Salim (40) was married, and a rickshaw puller. He had lost his parents in childhood before migrating to the city. As an orphan, Salim had ended up on city roads, working as a tokai, collecting paper, bottles and rags from garbage sites in Bangladeshi cities. He had had bitter experiences of being “hit, kicked and punched” -- a common scenario in the lives of tokai, and later migrated to Pakistan where he had worked as a fisherman. Soon after starting to work in Pakistan, and as his financial situation had improved, Salim started to feel gorom (literally meaning hot, here he meant sexually aroused). He reported having sex with women who used to visit the house he lived in, usually on weekends, in the guise of beggars.

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They used to come as if they were beggars, [but] they did this sort of business [sex] in the name of begging. If people ask, they say, “We’ve come to beg.” They would chat like … “How many people do live here in this room? … Do you want to do this sort of work [sex]?” The one who is senior [among Bangladeshi men living in the same room] would say, “We don’t have women. So let’s go do it [sex].”

He added that he had had sex in this way once or twice a month for a period of about two years. However, later he developed the idea that having this kind of sex was not good, because he felt it made him physically weak.

There’s a cahida [desire to have sex] on my mind. I’d gone there [to Pakistan] as a newcomer. I’d made some money, so I was a bit gorom [sexually aroused]. Later I realised, no, it’s harmful. If I do this [sex] once, I realised that the following day I wouldn’t have the strength anymore to pull a rope in the sea [to catch fish while on a large boat]. The power was going down. Then I backtracked. No, this is harmful for us. Let Allah not make this [sex] happen to me. [I felt] if I get sick somehow, I won’t survive.

So Salim decided to save himself for marriage. This account suggests that fear of losing physical strength and thus the ability to work may motivate some men to not have paid sex. After living in Pakistan for ten years, Salim returned to Bangladesh where he started rickshaw pulling and got married.

The narratives of baire jawa (going out to have sex in this case) provided by Salim and others suggest that economically marginalised married men’s access to new money, often gained through employment away from home, along with the homosocial bonds forged with other men in the context of work (such as fishing and garment factory work) elevate the likelihood of engagement in extra-marital sexual practices.

Finally, a small number of men reported having engaged in some form of non-partnered sex. Much of this non-partnered sex had taken the form of haat mara (masturbation) following feelings of sexual desire. Later in life, men of this social generation described watching pornographic movies and pictures, experiencing sexual arousal and ejaculation. However, most men viewed partnered and penetrative sex as the “real” form of sex, and expressed shame when talking about these non-partnered sexual activities. A substantial number of men viewed non-partnered sex such as masturbation

105 as both sinful and harmful. Dulal mentioned that he had lost too much semen through haat mara and swapnodosh (wet dreams), causing him to lose bodily strength.

Masud (37, van driver) described being “spoiled” by his male friends after divorcing his first wife. He started smoking and hanging out with them, occasionally going to watch “naked movies” secretly organised at a private house in the city. After paying a small entry fee, Masud and his friends would “message”18 (that is, massage) their lingos (penises) in the dark room while watching the films. His friends told him, “Dosto, do message like this; it will feel good.” Masud thought he had lost too much semen because of this. When he remarried, he reported having erection and premature ejaculation problems, which he attributed to losing too much semen through masturbation while watching these films. Several other men, such as Nazrul and Masud, described having seen pornographic movies in cinema halls or on mobile phones and computers. Nazrul mentioned how he used to go to see sexually explicit films along with his male friends before his marriage:

We would watch movies at theatres. There is a cinema hall opposite Banani [in Chittagong]. There they used to screen two movies for one ticket. I watched ek ticket e tuiti chobi (two movies for one ticket) many times along with friends.

Typically, one of the two of the movies would be pornographic. Significantly, the men’s narratives indicate that although these forms of sex were cited as non-partnered in the sense that the men involved were not sexual partners, but men’s enjoyment of pornographic materials and /or engagement in masturbation was strongly shaped by homosocial bonds.

In brief, middle social generation men’s sexual practices reveal similarities but also notable differences, compared to their older counterparts. While most men of this social generation organised their sexual lives within heterosexual marriage and kept their pre- marital romantic relationships pobitro (pure), a small number of men deviated from this pattern in the context of rapid urbanisation, economic transformation, work opportunities in urban factories, the availability of sex workers and strong homosocial bonds in urban settings.

18Masud incorrectly used the English word message to mean massage.

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Younger social generation men’s sexual practices

In the younger men’s accounts, religion appeared to play a less important role in influencing their sexual practices than was the case with the older men. Compared to their older counterparts, participants in this social generation reported less involvement in religious activities and all but one mentioned that they had engaged in some forms of pre-marital sex. Influenced by rapid social and cultural change linked to globalisation, urbanisation, economic development and educational opportunities, these men expressed more secular, urban forms of masculinity, which were different from the more traditional and idealised forms of Islamic masculinity enacted by older social generation men.

Unlike most men in the other two social generations, younger men spoke openly of their engagement in pre-marital sex and reported having had pre-marital sexual relationships with women or men or both. Several men reported having had penetrative sex within prem relationships, in contrast to middle social generation men, who did not report having sex within prem relationships. Roshid said that he had had penetrative sex with his premika (girlfriend) at her house when her parents were away from home.

However, a common theme in young men’s accounts of their sexual practices was the irregularity and secrecy of sex. They cited several reasons for this: social disapproval of pre-marital sex, parental surveillance, fear of being caught while having sex, and the possible break-up of relationships. Men expressed feeling afraid to have sex because of social repercussions if their parents or others learned about pre-marital sexual encounters. In order to avoid the parental gaze, younger men reported that they had had to have sex when parents or other family members were away from home. Pial’s case, for example, illustrates this point. He had been hiding in a bathroom when he went to visit his girlfriend, because although her parents were away, the girlfriend’s brother suddenly came back home. Later, he had gone up on the roof and climbed down a tree so that nobody would see him visiting his girlfriend’s house. On another occasion, Pial said that he had got into trouble after his parents and neighbours suspected that he had had sex with a girl in his parent’s house where he lived. After this incident, he could not bring his girlfriend to his house for two months. Instead, he would meet her in a restaurant to avoid detection. Pial explained that the restaurant offered a physical space

107 in which non-penetrative sexual activities such as touching and kissing could take place unseen, even by other people there.

Similarly, Babor reported having sex with a premika who lived in his neighbourhood and attended the same school that he did. His father wanted him to marry his cousin, but he did not want to do this because he was in love with the girl living in his neighbourhood. At the age of 18 years and before his marriage to his father’s chosen bride, he often went to his premika’s house at night to have sex when everyone in the village was asleep. Two of his friends would stand in front of the house to alert him in case anyone found out.

Other men of this younger social generation referred to non-penetrative sex. Some Dhaka-based university students, who earlier had studied at English language schools, used the term “making out” to refer to non-penetrative sex, which, they said, included kissing and touching. Here, generational differences in the use of language are also noticeable. As Plummer (2010) points out, different social generations tend to have different sexual vocabularies. While older men used the term “kopano” (digging), and middle social generation men including older men used kora (doing), deya (giving), etc., younger generation men used the English terms such as “making out” or sex. Foysal, a university student, mentioned that he had had a long-distance romantic relationship with a Bangladeshi girl living overseas. He had been introduced to her through Facebook. When the girl had visited Bangladesh, Foysal had met her and they had “dated”. Later, Foysal stated, he had “made out” with her, which included kissing at his parents’ house, when his parents and other family members were away.

These interviews reveal the relevance of institutional forces, such as religion and marriage in shaping men’s sexual practices. As marriage and religion are powerful social institutions governing sexual life in Bangladesh, and as men of this social generation sometimes engage in pre-marital sex, younger men indicated that they had to seek out suitable spaces to have sex without the knowledge of their parents or neighbours.

However, not all men of this social generation expressed the same views or reported the same behaviour. While most mentioned that they had had some form of pre-marital

108 sexual and romantic relationships, Nurul said that he did not want to waste his time by engaging in any faltu kaaj (bogus/useless work), which for him included trying to engage in a romantic or sexual relationship with a girl. He saw pre-marital relationship as faltu kaaj because his moral and religious views did not support pre-marital sex. Additionally, being relatively poor, he felt that his work was more important to him. Unlike other younger social generation men, Nurul had dropped out of school after finishing class eight, and had since been working as a security guard at a college. His father, a carpenter, and his mother, a housewife, had not allowed him to develop any romantic or sexual relationship with any girl. Nurul worked at a women’s college where he saw many girls and women. He thought that it was natural for men to feel attracted to women, but claimed that he considered the girls in his workplace as “sisters” and that he always kept spatial distance from them. Nurul’s was a rare case of continuity across the social generations, as he enacted the idealised form of Islamic masculinity, which was also enacted by older social generations of men, as discussed earlier.

Younger men’s narratives further suggest that there may be intra-generational differences in the number of sexual partners that they had had, which may in turn be tied to sexual subjectivity. In comparison to straight men, same-sex-attracted men Helal and Fahim reported that they had been in sexual relationships with numerous men. Like them, Nahian also reported having had many sexual encounters with both men and women. All three younger social generation men said that their sexual partners were so numerous that they could not remember how many sexual partners they had had. Thus, these three men’s sexual practices differed from the other younger social generation men and the older counterparts. The men’s accounts also indicated that since straight men do not experience the homophobia and stigma attached to same-sex relations in Bangladesh, they could continue their relationships for a longer time, unlike the experiences of same-sex-attracted men.

The topic of paying for sex also came up for discussion in the interviews with these younger men. Unlike most older social generation men, several younger social generation men reported having paid for sex. Roshid described having visited houses and other locations in Northern Dhaka along with his male friends:

Well, there’re hotels and there’re houses too. If one goes to Uttara [an area in Northern Dhaka], there’s no shortage of those places. Suppose, in Uttara they

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rent a house for 15,000 or 20,000 taka [per month]. There’re no people [no tenants living in these houses], but this business is going on. House owners are getting rent regularly without any problems. I know places like this.

Despite his knowledgeability, Roshid insisted it was peer pressure that had encouraged him to visit kharap jaiga (“bad places”, such as hotels and brothels where sex occurs in exchange for money). In such locations, sex typically lasted only a short time and for Roshid was not that enjoyable because of the fear of being arrested by the police or being seen by someone who knew him.

Some had thought about visiting kharap jaiga, but events had prevented it. When he was a college student in Dhaka, Russell once requested his friends to take him to visit the ondhokar goli (dark lanes). He said that he was curious about these places. As he was a student at a highly reputed college and the son of a respectable high-level government employee, Russell’s friends perceived him as a valo chele (a good boy). They refused to take him to the ondhokar goli, for which he said he was grateful, realising that visiting such places would have been a vul (mistake). Besides this, Pial cited lack of emotions as a reason for not paying for sex with what he referred to as khanki (derogatory Bengali term referring to women who sell sex). He explained:

No, I don’t like relations with kharap meye (bad women). They’re khanki. They don’t have any emotions. What I heard is that they just stretch out their two legs and then say, “Do.” There’re no feelings in this. I want to feel. Suppose, it’s like, I’ll touch a girl’s breasts and suddenly her breasts will tremble. This is what I want to experience.

While lack of emotions was described as a reason for not visiting sex workers, other reasons such as concerns about safety, and loss of social reputation and honour were also cited. It appeared that they had little or no concerns about STIs. However, Foysal, a university student, described those places as unhygienic because multi-partner sex happens in them.

By contrast, a few men of this social generation such as Babor and Roshid said that they had visited hotels, rented houses and met women on the roadside in Dhaka and Gazipur. They claimed that they had visited such places as the result of peer pressure. Some regretted that they had visited such places because they wasted their money and they had not enjoyed sex because of concerns about police harassment and the loss of social prestige.

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Socio-economic background appears to be linked to men’s sexual practices, with younger social generation men belonging to lower class reporting multiple episodes of baire jawa, Babor’s story can be used to illustrate this point. Because of his lower social and economic background, he enacted a different form of masculinity, compared to his middle/upper middle class younger social generation men, who claimed that they had never been to hotels to have paid sex. Babor looked after deliveries and had a wooden cart with which he carried building materials. At the time of his interview, he had been living in Gazipur for about four years, having migrated there from his home village in another district. Babor described how his first sexual encounters had been with his male friends in his village when they were teenagers. After he had married, Babor found it difficult to survive and provide financially for his family. To seek a better life, he decided to migrate to Gazipur, leaving his wife in the village. He initially worked in a garment factory where he received about 3,000 Taka (about $AUD50) per month. After payday, he used to go with his male friends to hotels in Dhaka to have paid sex with women. Apart from this, he would also have sex with women who were available after dark by the roadside in Gazipur. He had not always enjoyed this, however, feeling that the woman’s body was not always clean, with body fluids present from previous partners and other men waiting their turn to have sex with the same woman. Body fluids remained in the woman’s body because sex happened by the roadside where there were no facilities for cleaning. His wife followed him to Gazipur a few years after he had moved to the city, and after this Babor claimed he visited the hotels less frequently.

Younger social generation men’s narratives further suggest that their access to modern technologies, such as the Internet, computer, television and smartphones enabled them to easily access sexually explicit materials. Most reported watching pornography online, unlike some of their middle social generation counterparts, who had visited cinema halls for viewing pornography. Similarly, Roshid, with low literacy skills, described how he watched sexually explicit material on the Internet. Because he did not know how to use the Internet himself, one of his more educated friends helped him find materials online. They would both do this at his small shop in Gazipur.

Thus, compared to their older counterparts, the sexual practices of younger social generation men were significantly different in terms of their occasional, secret, irregular

111 engagement in pre-marital sex and non-penetrative sex. While most middle social generation men were concerned with purity in prem (pre-marital romantic relations) relationships, many younger social generation men were not. Findings further suggest that their sexual practices and expressions were shaped by dominant Bangladeshi social institutions such as marriage and religion. Growing up in more sexualised global popular culture, they often found themselves in environments where pre-marital sex, or sex outside marriage, were still seen as largely un-Islamic and anti-social, giving rise to secret and irregular sexual practices.

Implications for men’s self-understandings and for masculinity

The findings presented above point to the implications of masculinity for men’s sexual practices across three social generations studied. Islam and traditional Bangladeshi cultural norms appeared as significant forces shaping older generation men’s enactment of masculinity. These values were reflected in them not having sex before marriage and not engaging in extra-marital sex, while at the same time performing different types of religious rituals. Older social generation men’s perceptions of sottikarer purush (real men) were linked to their demonstration of sexual prowess and fidelity within marriage. Lack of sex in older age, along with diseases and disability, posed a challenge to older generation men’s sense of manhood as tied to sexuality, with many taking up and investing more heavily in other expressions of ideal masculinity, particularly through their greater involvement in religious activities.

It is clear from the material presented here that the sexual practices of the middle social generation men were also intimately linked to notions of masculinity and manhood and vice versa. Heterosexual prowess enacted within marriage was the hegemonic form of masculinity, which these men aspired to. As discussed in the previous chapter, most men of this generation perceived themselves as sottikarer purush (or real men) because they believed that they could sexually satisfy their wives. However, a few men of this generation reported experiencing sexual health problems including semen-loss, their semen becoming patla (thin, i.e., too liquid), premature ejaculation and sexual impotence. These problems were seen as barriers to the demonstration of sexual prowess and thus posed a challenge to men’s notions of masculinity, with some not feeling like a sottikarer purush.

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The concept of sottikarer purush, or being a “real man” informed the aspirations and sexual practices of perhaps the majority of participants from older and middle social generations; influencing getting married, displaying sexual prowess within marriage and not having sex outside marriage or within prem relationships. Crucially, men who reported experiencing sexual health problems did not see themselves as sottikarer purush in this sense. In addition, men who felt themselves to have “wasted” their semen through masturbation, the use of pornography, having wet dreams or having sex with men or women other than their respective wives, did not perceive themselves to be living up to the ideals of a sottikarer purush.

Notwithstanding some of these men’s deviation from this form of traditional, Islamic masculinity at some stages of their lives, all men in the middle social generation aspired to this hegemonic masculinity. They attributed any deviation from this ideal, such as having extra-marital sex, to the influence of strong homosocial bonds and friends who had “led them astray” by exerting peer pressure. By attributing their sex outside marriage to peer pressure, men attempted to present themselves as decent persons, who only sometimes crossed the normative boundaries of sexuality and heterosexual hegemonic masculinity, at least as characterised in a South Asian context.

Finally, younger social generation men’s sexual practices revealed both generational similarities and dissimilarities. One important difference was their engagement in pre- marital sex, compared with most of middle social generation men and older counterparts. Given that pre-marital sex is neither in line with Islamic sexual ethics nor traditional Bangladeshi cultural norms relating to sex, this finding reflects a significant shift in the views of sexual morality, which may be linked to exposure to global popular culture (where a diversity of sexual contents and discourses are easily available and where sexual encounters and liberties are normalised). Younger social generation men were also exposed to other cultures, growing up in cities that offer opportunities for alternative lifestyles, including sexual lives. Despite changes in sexual attitudes, men of this social generation often had to negotiate the traditional norms and moralities, which still prevailed in the society around them and among people from older social generations, including their parents, neighbours and relatives.

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Chapter 6: Men’s sexual health and help-seeking practices

Introduction

To explore more fully the implications of generational masculinities for men’s sexual well-being and health, this chapter focuses on men's use of sexual health services and their help-seeking practices. More specifically, it focuses on the sources of sexual health services and information accessed by different social generations of men, the kinds of information that the men gathered from these sources, and the perceived usefulness and adequacy of the services and information received. This is because gathering health information is an important first step in seeking help and health services. The chapter then moves to examine cross-generational differences and similarities in the types of information collected and services accessed before looking more closely at men's help and health-seeking in relation to problems encountered, including sexually transmissible infections (STIs).

For the purpose of this thesis, a distinction needs to be made between help-seeking and health-seeking. While the term “help-seeking” has been used to refer to the use of formal or informal supports in general from sources such as health facilities, media, family networks, friends, traditional healers, religious leaders, health workers, counsellors, and schools, professional care providers, the term “health-seeking” is usually used more narrowly to refer to seeking services or remedies for a specific ailment, illness or disease (Barker, Olukoya, & Aggleton, 2005, p. 316).

Briefly, the findings suggest that men’s health and help-seeking were a gendered process in the sense that, according to Saltonstall (1993), their “doing of health is a form of doing gender” (p. 12). Men’s enactment of gender appeared linked to their notions of being a man in a Bangladeshi cultural context. Moreover, the men seemed to adopt generation-specific beliefs and practices that were linked to their ideas of social generational masculinity within this setting.

This chapter is divided into four sections. Each of the next three sections explores the men’s understandings of sexual health, including sources and types of sexual health information and health services sought. In particular, each section focuses on the

114 participants’ understandings of safe sexual practices, patterns of media use and knowledge of STIs, including ideas about HIV and AIDS. Special attention is paid to the men’s health and help-seeking practices and the socio-economic and cultural forces that were seen as shaping these. The final section makes some concluding remarks.

Older social generation men’s sexual health and help-seeking practices

Help-seeking practices

Many older social generation men’s narratives indicated that they did not seek help for major problems linked to personal circumstances, mental health problems, and financial hardship. Bazlul’s (about 70-75 years, retired) had been suffering from multiple health issues, including durbalata (weakness), insomnia, and breathing problems. He was no longer able to work. He complained that his adult sons had not been providing him enough money and food. Overall, he said that his life was miserable and he wished he had died. He told me that he had twice planned suicide to end his suffering:

I’ve durbalata [weakness], my knees and legs become numb after I walk for a while. I also have headaches. I went to kill myself two times by going under vehicles [train]. The buri [meaning the old woman, his wife] lives with me. Not seeing me at home, she asked sons to find me. I’d walked towards the railway tracks. My sons brought me back home.

Bazlul had attempted to kill himself by throwing himself under a train, but he was unsuccessful, because his adult children had brought him back before he could reach the train tracks. Research has shown that men’s reluctance to seek help is associated with their enactment of masculinity (Courtenay, 2000a; Noone & Stephens, 2008). Western literature shows that men are four times more likely than women to commit suicide on average, with higher rates reported for older men (Courtenay, 2011, pp. 4-6). In Bazlul’s case, not seeking help was also influenced by his old age, poverty, lack of support services and so on.

Similarly, Halim (70 years, security guard) also thought that he had a life full of sorrows, but he did not usually seek help from others. Instead, he believed that Allah (God) would someday come to his aid. He said that he had often cried out and prayed to Allah, adding that he had disclosed these experiences only to me during the interview.

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Turning now to health information-seeking19, when asked to reflect on how they had first learned about sex and relationships, older social generation men offered a variety of responses. Whilst some men of this social generation felt that there was no need for teaching about sexual matters, others explained that they had learned about sex mainly from religious leaders and from people who were older than they were. Those who had not felt the need to seek out information concerning sex believed that sex occurred naturally. Bazlul (about 73 years, retired) and Halim thought that there was no need to learn about sex from anyone else as they believed that knowledge best derives from one’s own experiences. Bazlul said:

Why would I learn? One can automatically understand this. It doesn’t need to be learned from others … It’s like … melamesha [sex] will occur when she will feel like to be an ashiq20 [sexually aroused] and I also feel like to be an ashiq at the same time.

Bazlul saw sex as a “natural” instinct that would arise automatically when two persons of the opposite sex were together. Forkan echoed Bazlul when he said, “It’s intuitive. Your body automatically lets you know.” Adil (about 75 years, retired) said that sexuality had never been discussed when he was younger. He said, “Everything else was discussed except this thing.” Similar to other older social generation men, Adil added that it was Allah who had helped him learn about sex: “Allah made me know about this. Since childhood, nobody had been telling us about it [sex]. It happened automatically. Nobody teaches it to others.”

Adil’s quotation here highlights the taboo attached to the discussion of sexual matters when he was young, although he did later state that he had learned from older people that pregnancy could occur through sexual intercourse and that babies could be born as a result. However, he also insisted that babies could be born without sexual intercourse if Allah wanted them to be so, reflecting the influence of his faith and religious beliefs.

19 Health information-seeking practice is understood here as a help-seeking practice, because seeking information about health is one of the first steps to making decisions about health problems (Manierre, 2015). Seeking help also requires men to acknowledge their vulnerability, which may conflict with masculine ideals such as strength, courage and independence. 20 The phrase ashiq literally means lover, but here the participant used this term to refer to sexual arousal.

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Based on their accounts, several explanations can be provided for older social generation men’s reliance on these traditional sources of information. First, many men reported believing that religion held the answer to almost everything in life. Some older social generation men felt that there was no need to learn about sex because they were of the view that it took place according to the will of God. Second, because many older generation men had dropped out of school after one or two years, living in villages without the use of modern technologies, they had had to rely on more traditional sources of knowledge and information with respect to sex and other related matters.

Much of the information that men of this social generation gained from traditional sources regarding safety in sexual relationships focussed on the need to avoid sex during menstruation because of the “impurity” ascribed to bodily fluids by Islam and also other religions such as Hinduism (Anwar, 2006). Some older social generation men reported having learned about the importance of “staying away” from sex during times of menstruation. Mohaddes (about 53 years, rickshaw puller), for example, thought that it was also not appropriate to share a bed with a menstruating woman. Other men of this generation associated menstruation with beram (sickness), believing that body fluids passed through menstruation could cause harm to both men and women. Several men also believed that sex during menstruation was prohibited by teachings in the Hadith. Scholars of Islam are, however, divided on this question, with some reporting that the Prophet Muhammad often “embraced” or “fondled” his wives during menstruation (Shamoun, n.d.). In contrast, others say that the Prophet Muhammad’s wife Ayesha slept on a separate bed during menstruation (Shamoun, n.d.). Mohaddes, like other older social generation men, had heard about the prohibition on sex during menstruation:

I didn’t know the rules at that time. I did [sex] whenever I wanted. Later I learned from older people that it was indeed harmful. And my wife’s grandfather said that when this [menstruation] occurs to a woman; one must not share bed with that woman. You’ve to be on a separate bed. [The grandfather said] “Suppose if I’m on this bed, your grandmother should be on the floor. You’ve to be like this, let alone do melamesha [sex].” Isn’t it harmful? If that wasn’t the case, why would they give such an advice?

Mobin stated that he had learned from older people that it was necessary to take a bath after sex; a common practice in traditional Bangladeshi village society. It seems that the root of this practice lies in Islamic beliefs; people believe that according to Islam, taking

117 a bath is farz (compulsory) after sexual intercourse. Mobin recounted how he had been advised on his wedding night to take a bath in a pond (located at a distance from home) before dawn so that nobody would know that he had had sex, as there was and still is a taboo around sex. He claimed that he had acted according to this advice to appear as a responsible, good Muslim man.

In addition, sex soon after childbirth was also believed to cause harm. Mohaddes described how he had learned, soon after becoming a father, that husbands should practise abstinence from intercourse with their wives after childbirth. In the village where he had grown up, home births were common and often attended by untrained traditional birth attendants; in such settings, birth-related complications were common. After childbirth, he had gone to visit his wife’s father’s house. There, his wife’s grandfather had advised him not to have sex after childbirth. Mohaddes explained:

I went to my mother-in-law’s house. I learned it from my wife’s grandfather. I talked with them. I’d a chat and discussed funny topics. These issues were raised when I used to visit them. He said, “What’s the matter? After a while [after marriage], a grandchild has been born? These things happen. Don’t touch at this stage. It will cause harm. It will cause harm to you and to the woman.” This is a saying of the Hadith [Instructions by the Prophet Muhammad]. There might be allergy and blood in there [genital area]. One should not have sex at least for 40 days after childbirth.

Some Islamic scholars have suggested that sexual intercourse is prohibited by Islam only in contexts where there is the possibility of postpartum bleeding, while there is no restriction on sexual intercourse if there is no bleeding or birth-related complications (Anwar, 2006). Mohaddes developed his understanding of the importance of abstinence through interaction with a learned older man with whom he had a friendly relationship. In Bangladeshi culture, a man’s relationship with his brother’s wife, his grandfather, his grandmother and his wife’s sister, among others, are generally seen as tatthar somporko (humorous relationships which are somewhat freer and less hierarchical). Despite the taboo attached to sex, information and advice about sex may often be disseminated through traditional social networks in a light-hearted way, as the conversation between Mohaddes and his wife’s grandfather suggests. By not having sex after childbirth, Mohaddes tried to act according to what he saw as the dictates of Islam, as a good Muslim man and as a responsible new father and husband. As discussed earlier in

118 chapter 4, responsible fatherhood and being a good Muslim were central to notions of masculinity for older social generation men.

Older social generation men’s narratives also suggest that they did not have much awareness of what today might be regarded as safer sexual practices with respect to sexually transmissible infections (STIs). After I explained what STIs were, almost all reported that they had not heard about condoms, STIs, HIV and AIDS. One likely reason was that they did not have access to mass media and education; almost none of the older social generation men, when they grew up, had access to modern technologies such as televisions and computers, and some even saw watching television as “un- Islamic”. In addition, HIV had not emerged as an issue of concern when they were younger.

The few older social generation men who had heard about STIs and HIV did not seem to know what these meant. Amir (55-56 years, security guard) said, “I hear about HIV, but what is it? I don’t know how to read or write.” As one of the few men of this social generation who did have access to television, he added that he often followed news on television, but did not pay attention to issues like STIs about which little information is generally disseminated through Bangladeshi mass media. To give some examples of men’s little understanding of HIV and/or STIs, Forkan mentioned that he had heard that “condoms can cause cancer” from his poribar (wife), while Mozammel believed that he did not have AIDS, because he had not donated or received blood:

I heard about it, but I don’t have it. I heard that ... Suppose a man went to Dhaka and he’ll get admitted into a hospital and he’ll donate blood. And if he ... if ... blood is put into a bottle, he’ll have it [HIV/AIDS], won’t he?

Health-seeking practices

With respect to health seeking for specific health issues, there were few medical doctors in the villages where older social generation men had grown up. Adil (75 years, retired) said, “In our times, there were kabiraj [traditional healers] only.” Because of this, men had had to rely on herbal medicine, traditional healers, or religious leaders for advice about or treatment for health problems. Adil, for instance, had sought help from kabiraj and taken herbal medicines for fever. He also believed that medicines held little power.

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As mentioned earlier in chapter 4, he belonged to the local Tabligh Jamat and when he was ill, he only saw a doctor or a kabiraj because he believed it was his sunnat (the duty of a Muslim as a follower of the Prophet Muhammad) to do so:

Yes, I did. I’d fever or cough, I went and they prescribed medicines. Medicines don’t have any power. Power lies with Allah. The Prophet used medicines and so we’ve to take medicines as sunnat [actions done to emulate the Prophet]. We’ve to remember this. [But] if we say, “I’ll get cured if I take medicines”, that will be a sin. … If we take medicines as sunnat, Allah will bless us.

Like Adil, Mobin (62 years, rickshaw puller) had not sought professional help for health problems. However, he had done so for fever, buying tablets from a pharmacy and being cured “by the grace of Allah.”

Because older social generation men saw sexual prowess as a manly characteristic, they tended to understand the ability to have sex as an important dimension of sexual health. They reported a variety of problems that are well-documented in the South Asian literature (Collumbien & Hawkes, 2000; Lakhani, Gandhi, & Collumbien, 2001; Rashid, Mahmud, Akram, & Standing, n.d.; Majumder, 1999; Hawkes & Collumbien, 2007; Khan et al., 2006b), including swapnodosh (wet dreams), sexual impotence, erection problems and premature ejaculation. For Amir (56 years, security guard), sexual health problems also included problems with the quality of one’s birjo (semen), thickness being an important criterion. Overall, however, the majority of older social generation men described their sex lives as having once been satisfactory, especially when they were younger. They felt that it was only natural to encounter sexual health problems in old age. Demonstrating with his finger, Mozammel (about 72 years, retired) explained: “Suppose my lingo [penis] is now like this. It doesn’t stand [erect]. Previously it was like this [it used to be erect].”

Halim (about 70 years, security guard-cum-caretaker, formerly jute mill worker) also reported experiencing a loss of libido. He said that he had not been experiencing uttejona (arousal) for a long time. His wife was much younger than he was and his loss of libido was a matter of lojja (shame) to him because of this. Halim said that because of his wife’s younger age, she experienced uttejona, which he was not able to satisfy. Amir and Halim said that their semen was patla (too liquid) and that they experienced

120 premature ejaculation. Forkan (about 56 years, rickshaw puller) attributed his inability to have sex to fate and to sickness:

So I’d got married, and then ... I mean do people remain the same all the time? Many things happen … like diseases, sicknesses … I can’t have it [sex] anymore. If Allah doesn’t want, what’s the point of forcing and doing things like that? … I’m in trouble. I haven’t been doing very well lately.

By being in trouble, he referred to sickness, diseases and his inability to have sex. Similarly, Mobin (62 years, rickshaw puller) reported that he had been having sex less frequently than he wanted because his wife was ill and had undergone an operation. As a self-described songbedonshil (sensible man), he felt that there was no point in causing julm (harm) to his wife by trying to force her to have sex with him: “Yes it [sex] occurs, but after the operation, the woman is like, she is a bit durbal [weak]. After a while, she asks to stop since the operation. So I just do as long as she can. I can't do any julm because she is a patient. That’s it.” Some (such as Halim) appeared unhappy about the loss of libido. This in turn led to some of the health-seeking practices discussed below.

The issue of health-seeking for specific health problems such as infertility, “semen- loss”, and old-age-related diseases and illnesses came up for discussion towards the end of the interviews. Overall, however, the narratives of older social generation men suggest that seeking care for sexual health problems was the exception rather than the norm. Most of the men interviewed said that they had never sought professional or other types of help for sexual health problems, although some had sought treatment for other health issues, including minor illnesses or diseases. The main reason for not seeking health care was that most older social generation men saw themselves as sexually healthy and believed that they did not have problems requiring professional help. Such a perspective was in line with their accounts of being sexually potent when young but experiencing a “natural” decline as they aged.

Apart from this, notions of having a strong body and a belief in the Almighty Allah shaped older generation men’s health-seeking actions. Mobin, for instance, saw himself as free from any diseases, although he had never been tested for STIs or for any other condition. He thought Allah was merciful towards poor men such as himself, who would not have been able to pay for treatment. Several other older social generation men also positioned themselves in relation to Allah in this way. As an omnipresent and

121 all-powerful entity, Allah was seen as exerting strong influence over men’s health and even their deaths. In line with such a perspective, during his interview, Mobin opened up his shirt and showed me his chest, saying:

No, I haven’t done any tests. I didn’t go to doctors. I haven’t noticed any problem within the body. As I’ve shown you my body, there’s no allergy or spots on the body. There’s no disease inside the body. Allah has forgiven me. Because if I need to go to a hospital, suppose, if I need to pay 10,000 taka … I won’t be able to pay because I don’t have any money. I’ve my Allah, and my Allah has kept me free from diseases.

His quotation reveals how a combination of cultural beliefs about good health, low income and religious beliefs together shaped men’s health-seeking behaviours. As they had little understanding of STIs, all older social generation men reported that they had never been tested for them, nor did they believe there was any reason to do so. After I explained what STIs were and how these might be transmitted, they argued that, as they had not done anything that was kharap kaaj (or “bad”), there was no need to test for STIs. Even the two older generation men (Forkan and Mohaddes) who reported having engaged in sex with multiple partners seemed unaware of the possibility of sexual health problems. As mentioned above, Forkan believed that condoms could cause cancer. He also mentioned that he had not used condoms while having extra-marital sex. Thus, older social generation men’s narratives suggested that they had not been informed about potential sexual health problems such as STIs linked to unprotected sex.

Overall, only a few of older social generation men interviewed reported having sought health care for sexual health matters. Mozammel (72 years, retired) said that he had once sought advice from a maulana or religious leader concerning swapnodosh, or nocturnal emissions. In Mozammel’s eyes, these were robbing him of his strength, which in turn made him weak and created headaches. The maulana had taught him a mantra or hymn to recite six times before going to bed. This, he believed, eventually stopped swapnodosh from occurring: “It [semen] came out and it kept on coming out, then you’ve headache and then you get weak. That’s why, I said this to the maulana. I got well.”

Halim (70 years, security guard), on the other hand, had visited doctors who practised Western medicine, as well as traditional healers, such as hekim and kabiraj, for treatment for his infertility and sexual impotence, both of which had challenged his

122 sense of masculinity. He expressed frustration about the treatment, however, because no pregnancy had occurred after the death of first baby and because the treatment had improved his sexual prowess only slightly and only for a short time.

In summary, older social generation men’s desire to adhere to Islamic values and traditional Bangladeshi cultural norms influenced their understandings of sexual relationships and sexuality, affecting their sexual health information-seeking. In the absence of access to modern information technologies and lack of opportunities for formal education, older generation men tended to rely on mainly traditional channels, such as religious teachings and the family for information about sex and health-related issues. In addition, older social generation men’s cultural and religious beliefs and their low incomes tended to shape their health-related help-seeking practices. Of all three social generations in this study, they were the least likely to seek help for sexual matters because, overall, they saw themselves as healthy. When they did take medicines, they did so largely because they thought it was their duty to emulate the Prophet’s lifestyles or for the specific health issues described above.

Middle social generation men’s health and help-seeking practices

Help-seeking practices

Like their older generation counterparts, most men of the middle social generation said that they had not sought help in general either because they saw themselves as not needing to do so or because, as some reported, they felt lojja (shame) about doing so. Men of this social generation mentioned low income and prioritising their wives’ and children’s needs over their own as reasons for not seeking help for themselves. This was because as household heads, they saw themselves as responsible for the well-being of family members. Middle social generation men’s accounts suggested that they sometimes refused to seek help for financial hardships. Zeshan (51 years, college teacher) had lost about 5,000 000 taka ($AUD 90,000), which he had invested in a business. He said that he had not told anyone about this and he went to work the next day as if nothing had happened. As having money and not being too emotional were seen as important aspects of masculinity, his loss posed a major challenge to his masculine identity.

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Mazid (35 years, garment factory worker) also lived in a state of financial hardship and had relationship problems. His wife, a garments worker, who earned slightly more than he did, used to give her wages to her parents. She did not contribute to the family financially. Mazid said that his wife also complained about his osukh (sickness) or jauno somossa (sexual health problem). News of his jauno somossa was a bodnam (bad reputation) spread among his families, relatives and friends. His wife had wanted to give him one year to improve his relationship with her. But Mazid said, “Being a man, how can I let her monitor me. I didn’t want her to monitor me”, indicating how questioning of a man’s position and power in the context of family may produce masculine anxieties. Consequently, Mazid had sold off his household items to pay for a divorce, which made him poorer but still offered him a way of demonstrating masculinity. Mazid did not seek any help for this relationship problem and found it difficult to borrow from friends when he needed money for his child’s treatment.

Masculinities arising in the context of the gender division of labour and the constitution of the home as a women’s domain and the public sphere as a men’s world, also had implications for men’s help-seeking. Majid, for instance, said that he had not sought help because he had given more importance to his wife’s and his only son’s health care needs. His low income, coupled with his provider role, meant that he could not afford to see anyone about his own problems. Similarly, Khairul (35 years, vendor), as a household head, prioritised the care needs of his wife, children and his old mother. He believed that Allah was there to take care of him. This finding is significant because, contrary to the stereotypical representation of men as careless about themselves, it suggests that the construction of men’s provider role as an important dimension of hegemonic masculinity meant that men of this social generation prioritised the health needs of other family members over their own well-being.

Like their older counterparts, most middle social generation men expressed little understanding of the concept of jauno shaisto (sexual health). After I had explained the term to them, they said that korte para (being sexually capable) and not having a sexual health problem (such as premature ejaculation) were for them the most important aspects of good sexual health. Most middle social generation men believed in the need to practise restraint and sometimes abstinence to stay in good sexual health. They added

124 that beshi kora, or indulgence in what they saw as “too much” sex, could jeopardise their sexual prowess. Shahit (34/35 years, garments factory worker), for example, said that his grandmother had advised him to have sex no more than 12 times per month. He cited a Bengali proverb she had told him: Mashe baro, joto komate paro (12 times a month, the fewer, the better). Similarly, Shahit’s grandfather had advised him not to waste his semen. As cited in the previous chapter, he said:

When I was younger, my grandfather said, “Do not write with your own ink on someone else’s notebook. If the ink of a pen is used up, it can be refilled, but if a man’s ink is wasted, it can’t be refilled.” I still remember his advice. I think it’s very true. If once lost, will you be able to bring it [semen] back even if you try a hundred times?

Implicit here is the traditional belief that semen provides a source of bodily energy, generally associated with masculinity. Since wastage or loss of too much semen was viewed as causing weakness, men felt that once they became weak, they would not be able to have sex for a long time. Alim (30 years, van driver) described his experience of semen-loss as follows:

Once when my semen became patla [thin, meaning too liquid]. Do you know what I mean? It falls in drops [discharge keeps coming out] … The semen wasn’t thick at all. It had a water-like texture. This can happen after men have erections. A man becomes weak if he experiences this.

Other middle social generation men too viewed semen-loss as a sign of potential sexual weakness. As physical strength and korte para (being sexually capable) were constitutive of masculinity, in such circumstances men may feel vulnerable because they fear that they will not be able to satisfy their wives sexually.

Turning now to help-seeking over sexual matters, unlike their older counterparts, middle social generation men reported that they had obtained sexual health information from a more diverse range of sources. These included television, male friends, older people, schools, and Bangladeshi and Indian movies. Several men mentioned occasionally watching “naked” movies or “blue” films (meaning pornography) with their male friends. In addition, the two men from this social generation who had university degrees mentioned that they often read newspapers, but added that the newspapers did not contain much information about sex or sexuality.

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Apart from the sources mentioned above, middle generation men reported having learned about sex and relationships from other male friends.

We discuss it among friends. One says, “I’ve done two times.” Another says, “I’ve done three times.” Someone else would say, “I’ve mere disi (have had sex) this morning after coming back from night-shift work. I couldn’t do at night, so maira disi [have had sex] in the morning.” This is how it works. (Dulal, 46 years, office assistant).

Homosocial contexts, such as all-male groups chatting near tea stalls, in shopping centres, at universities, in cafes, parks and so forth were often valued sources of information about sex, sexuality and relationships. Through such means, Dulal had learned there were tablets that could increase sexual prowess. As described in chapter 4, Masud (37 years, van driver) said that he had first learned about massaging his lingo (penis) (i.e., masturbation) from his male dosto (friends). He had accompanied his male friends to a house in the city where “naked” movie shows were organised secretly for low-income men in exchange for a nominal fee. He added that his friends had encouraged him to massage his lingo in a dark room while watching these movies.

While many middle social generation men had heard about AIDS and could identify several modes of HIV transmission, almost none had heard about STIs more generally. Even though many were aware of HIV, some held misconceptions regarding modes of HIV transmission believing, for example, that washing the genital area with water after sex could protect against HIV transmission when condoms are not used. However, several men could identify a few ways of preventing HIV and/or AIDS (participants used the terms HIV and AIDS interchangeably, as did the HIV and AIDS awareness campaign in Bangladesh mentioned below). Most men said that people only get HIV through kharap kaaj (bad work), by which they tended to mean having extra-marital or pre-marital sex (most usually with female sex workers). They knew about HIV and AIDS because there had been campaigns on television and their slightly higher literacy levels than men of the older social generation allowed them to access information more easily.

Most men belonging to this social generation believed that the mass media did not provide adequate information about sex except in reference to HIV and AIDS. Nazrul said that he regularly read the health page of a newspaper, but he had not seen much

126 information about sexual relationships there. Some men of this generation were also critical of an old AIDS awareness campaign in Bangladesh whose slogan simply said AIDS ki? Bachte hole jante hobe (you have to know what AIDS is in order to remain alive). Nazrul added that the campaign did not say what needed to be known in order to prevent HIV infection, indicating the inadequacy of the information provided. Other middle social generation men, who had low incomes and low education levels, said that they did not read newspapers. Almost all middle social generation men wanted to know more about sexual matters, because inadequate information was disseminated through both traditional and modern means of communication in a conservative country. Most of these men were sexually active, unlike their older counterparts, and some had experienced sexual health problems for which little information seemed to be available.

As with their older social generation counterparts, middle generation men emphasised the importance of not having sex during women’s menstruation. Both social generations of men believed that sex during menstruation could cause harm to a man and was prohibited by Islam. Shahit had completed 10 years of schooling at a madrassa (an Islamic religious school) where he had been taught about issues like menstruation and masturbation. He explained that he had learned that women have a periodic osukh (literally means sickness, but here he meant menstruation) during which, he believed, a man should not have sex with his wife and should sleep in a separate bed to prevent disease transmission. He added that he had learned from one of his books at the madrassa that masturbation could be harmful. He said, “This book which I read in school taught me that this [masturbation] is bad for health.”

Health-seeking practices

Middle social generation men’s experiences of specific health problems and their health-seeking practices in relation to these problems were also discussed. While most middle social generation men saw themselves as sexually healthy, others reported that they had encountered some sexual health problems. Men also talked about others they knew who had encountered sexual health problems, including swapnodosh, thinning of the semen, and loss of too much semen. Mazid (35 years, garment factory worker), for example, said that his first wife had complained to one of his relatives about his sexual impotence, which caused him embarrassment. His second wife had also indicated that

127 she wanted him to have sex for longer, which Mazid felt unable to do. Because of this inability and some other issues (such as his low income and his inability to provide maintenance), his first marriage had ended in a divorce. For these reasons, he also felt that he was not a sottikarer purush or a real man. A few middle social generation participants also mentioned that they knew of men who had had dhojovongo (erection problems). Significantly, the Bengali word dhojovongo carries strongly negative connotations because it implies a complete loss of manhood. Perhaps as a result, men of this social generation sought to distance themselves from dhojovongo purush (a man who has erection problems) by framing the condition as a problem of other men.

Middle social generation men’s accounts indicated that their enactment of gender influenced their sexual health-seeking practices. Salam (35 years, van driver), Masud (37 years, van driver) and Dulal (46 years, office assistant), for instance, reported having visited a doctor for health problems, such as fever, stomach pain, shoulder pain and diabetes, but none of them reported visiting for sexual health problems. Dulal felt that with age, his “sex power” had decreased significantly, but he had not sought treatment for this problem because he was receiving treatment for diabetes and high blood pressure. He had also survived several strokes. On the one hand, his low income prevented him from receiving treatment for erectile dysfunction; on the other hand, he had to take care of expenses relating to his son’s education and household expenses. Through discussion, his wife and he had decided that he should begin treatment for diabetes, but having the responsibility for an adult child meant that seeking help for sexual health was not on his priority list. In many ways, Dulal’s “doing gender” (West & Zimmerman, 1987) as a household head limited his ability to seek professional help for his sexual health.

The majority of middle social generation men, like their older counterparts, said that they had not had any sexual health issues requiring help. Because, as good Muslim men, they reported not having had sex with sex workers, they felt that there was no need to seek professional help. For them, discussion of sex outside men’s informal social gatherings was a matter of lojja (shame) and doing so could harm a man’s reputation. Masud explained why he had not seen a doctor for sexual health and had never used a condom:

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I never needed to go to doctors for sexual health issues. Never for sexual health. However, I’ve been there sometimes, maybe for some temporary illness. Well I’ve seen other men use it [condoms], but I never used it. I think, what’s the point of buying condoms. I feel men who go to kharap meye [female sex worker] should use them. I don’t have any plans to use it [a condom] in the future. What’s the point?

Other middle social generation men who had had sex with multiple partners (including sex workers) stated that they had experienced some sexual health problems. They described two main scenarios. First, they were often late in seeking help because they hoped that the problems would heal automatically or they had felt lojja. Alim (30 years, driver) found it difficult to seek health care because of lojja when his semen became patla (thin, i.e., too liquid). When blood passed in his urine, Islam (35 years, office assistant) became scared, but could not tell anyone about this initially. Later, however, he secretly went to see a doctor in the early morning so that no family member would know about the incident.

In a strongly heteronormative cultural context where sexual lives and desires are organised within heterosexual marriage, sex between men and sex outside marriage may be seen as a matter of lojja (or shame), which is in turn linked to men’s sexual health- seeking practices. Khairul reported that he delayed seeking health care because of lojja. He suggested that the lojja was linked to an incident of sex that had happened between him and a male friend when both were much younger. Khairul and his male friend had not been able to seek any professional help and had instead gone to a local pharmacy to purchase medicines. He found himself in a doubly complex situation because he had had pre-marital sex at a relatively early age and secondly, penetrative sex had occurred with a male friend. His engagement in this form of sexual practice may be seen as transgressing the normative standards of sexuality and ideals of masculinity:

When I first disi [inserted] the whole thing [anus] got broken [fractured]. He was crying. I asked, “Why do you cry?” The situation was bad. Later from a shop… there’s an ointment … it had a horse mark … It’s called Millat balm … It cost only 4, 5 taka, or maybe 3 taka. I bought other things like chocolate to make him stop crying. Then he stopped. If parents knew about it, we would have to leave the area. We could get into lots of trouble.

Khairul’s quotation reflects his fear of social ostracism, stigma and prejudice because he had violated the codes of hegemonic, heterosexual masculinity embodied in being a sottikarer purush (real man). Although “the whole thing got broken” and his friend was

129 bleeding, they could not seek any professional help because it was not possible to talk about the sexual encounter with anyone. Thus, lojja and/or the fear of social isolation and stigma for engaging in “taboo” sex may explain some men’s reluctance to access appropriate health care.

By way of contrast, some middle social generation men reported that they had sought care for sexual health issues in order to preserve their sense of masculinity, such as to restore their sexual prowess. Salam had sought medical help because he realised that if his wife complained about his sexual performance, his masculinity would be threatened. Similarly, Masud’s interview indicated that he had sought health service from a doctor to deal with erection and premature ejaculation problems. He said that, in his view, wives could create many problems if they are not sexually satisfied. Because of this, he had decided to see a doctor:

She was a new wife. I was tense. If she suddenly says something [relating to sexual impotence], all my maan-izzat [honour] will be ruined. So I saw a doctor after four, five days of the problems. Later after taking the medicines, I found it useful.

By seeking help, Masud was able to enact a form of masculinity more aligned with both his own and his wife’s expectations.

Three important insights emerge from the middle generation men’s narratives presented above. First, they did not seek professional help because of “doing” particular forms of gender as the head of the household and /or as provider. In the context of low income, men may need to prioritise their wives’ and children’s health care needs over their own as heads of households to prove their masculinity. This finding challenges stereotypical representation of men as exclusively careless and violent towards women in South Asian contexts. Secondly, men’s lojja relating to sex with other men or sex outside marriage (both of which transgress hegemonic codes of masculinity) may also limit their ability to seek health care. Conversely, however, the findings showed that there were occasions when middle generation men did seek health care to preserve and retain particular aspects of masculinity such as sexual prowess.

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Younger social generation men’s help-seeking and health-seeking practices

Help-seeking practices

In contrast to men of the two older social generations, problems relating to relationship break-ups figured more frequently in younger generation men’s narratives. They also reported that they often found it difficult to sustain a romantic or sexual relationship with their male or female partners. Yet most men of this social generation had not sought any help for these problems given that they found themselves in society that is not accepting of pre-marital sexual/ romantic relationships. Foysal (25 years, university student) had formed a relationship with a young woman he met through Facebook. After their break-up, however, he found himself upset and in a difficult situation. Moreover, he said that he was also upset because he could not finish his studies for a bachelors’ degree in business, while most of his friends had earned their degrees and were working full-time. He had started performing namaz (prayers) to deal with his distress. He indicated he would not have prayed unless he was in a crisis, even though he identified himself as a Muslim. It should be recalled here that he, like many other men from all social generations, believed that a sottikarer purush has to be independent. Seeking help more formally may therefore have conflicted with his notions of manhood.

Younger social generation men suggested that they sought little help for sex-related problems. When questioned directly, many of them also had little clear understanding of the concept of sexual health. Although they did not know exactly what sexual health meant, they (especially men from Dhaka, private universities and higher socio- economic background) displayed a greater awareness of STIs, HIV, and AIDS than other younger and their older counterparts. Several of them were also concerned about sexual rights and two were sexual rights activists.

By contrast, younger social generation men who were from lower socio-economic backgrounds or who lived outside the capital city and had attended government school or university systems tended to have less or no information about sex and relationships. Roshid (27 years, electrician), Babor (22 years, van driver) and Nurul (19 years, office assistant) did not know what jauno shaisto (sexual health) meant. All three men had dropped out of school, unlike the other younger social generation men. Nurul thought

131 that married people were supposed to have better knowledge about sexual matters. He added that older people would brief him about sex at the time of his marriage, which would mark his entry into sexual life. He said: “What sexual health means ... those who got married, they’d understand it well ... I ain’t married yet, am I? … Had I been married, I would’ve known something about this. I haven’t got married.”

However, several young generation men, especially those who lived in the capital city and who had attended schools and private universities where English was the language of instruction, revealed that they did have somewhat better information about sexual health issues than did their older counterparts and fellow younger social generation men. Fahim (22 years, private university student and part-time NGO worker), for example, revealed having some basic ideas about sexual health. For him, “It relates to whether our sexual organs are functioning well.” For Fahim, who reported experiencing verbal abuse for being a kothi, the idea of sexual rights was also important. He was an activist and his future plan was to work for the rights of sexual minorities.

Russell, however, was an exception among private university educated younger men; he felt ashamed that he had not heard about the concept of sexual health before the interview. He insisted, however, that since his girlfriend was a medical student, he did not need to worry about preventing pregnancy through sexual intercourse, assuming that she would know about protection. He seemed not to display awareness of other aspects of sexual health. Private university students Pial (23 years) and Rahul added that they had kept condoms ready for use during sexual encounters in case such opportunities might arise. They also knew that condoms should be used to prevent HIV transmission and pregnancy.

Compared to older and middle social generation men, growing up in the information age, younger social generation men’s accounts indicated that they had better knowledge and information about condoms, STIs, HIV and AIDS. Nahian (27 years, researcher), Russell and Rahul, who attended schools and universities where English was the medium of instruction and who spoke both Bengali and English, reported accessing information about sexual matters from the Internet, television and friends. Younger social generation men like them could name a number of STIs, such as Chlamydia,

132 herpes, gonorrhoea, syphilis and HIV and AIDS. Foysal (25 years, private university student) said:

I came to know from TV and also from some promotional activities. I also use the Internet and so I see a lot of information regarding sexual health … In Bangladesh, most of the ads are about AIDS, HIV; but in other countries there are ads about other diseases like genital diseases like gonorrhoea, syphilis etc.

Although English language schools and private universities do not provide education about sex, sexuality and relationships, through attendance at them students gained access to the English language, which they could use to access the information they needed from the Internet. In contrast, those who attended government-funded universities or who had dropped out of schools could not name any STIs. Imran (20 years, public university student) said, “I just know about HIV only. I don’t know too much about the others [STIs] … We’ve just been taught the basics of HIV. Nothing more to elaborate [on STIs].”

Living in a sexually conservative country while simultaneously being exposed to a global popular culture in which sexual contents are readily available, the majority of younger generation men expressed dissatisfaction with the ways sexual matters were dealt with in Bangladesh. Karim (22 years, university student) stressed that not enough information about sexual matters was being disseminated, and that there was a need for more research on sex education. Some students from both public (Karim, for example) and private universities (Foysal and Rahul, for example) expressed dissatisfaction with the taboos about sex in Bangladeshi society and felt the need to learn more about sexual matters. Many of these same men reported that discussion about sex and sexuality at schools was either absent or cursory, perhaps because of cultural taboos and the framing of pre-marital sex as a “bad thing”. Karim, for instance, said that his school teachers had not discussed sexual issues at length. He spoke of his biology teacher who would just briefly mention about sexual matters: “We’d a biology teacher. Girls in our class were much more mature and asked a lot of questions. He’d try to avoid these topics, but he told us on a superficial level about things like menstruation, ovulation and things like that.”

Karim’s account suggests social generational differences in relation to the taboo ascribed to sex; female students asked questions about sexuality, while older teachers

133 did not want to talk about such matters. His narratives reflect how his higher secondary school may participate in the reproduction of the ideal Bangladeshi Islamic masculinity by avoiding discussion of sex, perhaps with the goal of preventing younger social generation men from having pre-marital sex and avoiding the lojja associated with discussion about sex. In addition, Karim mentioned that his social science teacher had talked a little about sex while discussing rapid population growth in Bangladesh. He said that the teacher attributed the high population growth to lack of alternative types of recreation other than sex. Karim added that there were some seminars on AIDS at his school, but not on issues like STIs or sexual health in general. This was because in the wake of global concerns about HIV and AIDS, policymakers, researchers and the Government of Bangladesh, as well as non-government organisations, specifically targeted HIV and AIDS, but ignored broader issues of sexual health including STIs.

While a few younger social generation men said that sexual issues had been discussed (albeit often superficially) at school, other men said that sexual matters were not discussed at all, even at secondary school level. Without access to information about sex and relationships through their families or educational institutions, they had had to rely instead on the Internet, friends and television to learn something about sex. Rahul (22 years, private university student) said:

These things [sexuality issues] aren’t discussed in our country. To know about this ... those of us who are youth, we have the Internet. We can see and know everything here. We can learn. I learnt these things from there. Another important source are friends. These topics aren’t discussed with family members. So we discuss these with friends. And we ultimately know from them.

Apart from these sources, younger social generation men also mentioned obtaining information about sex from books, social media and sometimes from pornographic videos.

Among the younger social generation men, only Rahul mentioned he had had an opportunity to attend a sexuality workshop at his university. He said, using English:

It’s a full-day programme. It’s very free [open]. It’s very elaborate and descriptive. It’s interactive. That’s a good one. Those things weren’t organised in schools. If this was done, it would have been good. If these are done, sexual health care will develop in Bangladesh. These must not be confined to English medium schools only. These activities are needed in all types of schools.

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In the sexuality workshop, he had learned about the importance of consent in sexual relationships and for the first time about female condoms. However, his experiences were a clear exception: no other men from any social generation reported having attended a workshop similar to this.

Unlike other men of his social generation, Russell was one of the few who relied both on traditional sources and on more modern sources of sexual health information. He regularly used the Internet to find out about sexual matters and felt he had acquired some useful information. However, Russell, unlike other younger social generation men, was also fortunate to have a close relationship with his grandfather through whom he had learned about purusotto (manliness) and what being a man involved. Other younger men did not talk much about their grandparents, as they lived in nuclear families in the city or their grandparents had not discussed issues of sex and sexuality with them.

Health-seeking practices

Turning now to health-seeking for sexual health problems, although younger social generation men reported that they had encountered sexual health problems, most of them sought little help for these problems. Some delayed seeking professional health care. For example, Roshid (27 years, electrician), described suffering from itching because of a bota (spot or rash) on his penis. He delayed a week before seeking help from a doctor because of lojja, and because he hoped that the problem would go away by itself. Similarly, Babor reported having suffered from durbalata (weakness) in his knees after visiting a hotel in Dhaka where he had paid for sex. However, because of lojja or shorom (shame), he had not sought any health care. Karim and Fahim also reported never having sought help. Karim mentioned that he had a pimples problem around his genital areas at the time of our interview, but lojja had hindered his access to seeking professional care for the problem. When I probed, he added that although lojja is considered a feminine characteristic in Bangladesh, when it comes to sexuality matters such as pimples around the genital area, it was alright for men to have lojja. He added however that he had sought advice from three close friends, one of whom advised him over the phone to take some medicine. In addition, all younger social generation men mentioned that there were not adequate sexual health services for men.

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In comparison to heterosexual younger social generation men, the health-seeking experiences of the three same-sex-attracted young persons were somewhat different, suggesting how minority sexuality may intersect with help-seeking practices. Unlike all other participants, they reported that they had been tested for HIV, perhaps because they perceived themselves to be at risk. HIV and AIDS intervention programmes in Bangladesh have indeed specifically targeted men who have sex with men, one of the main groups believed to be at high risk of infection. In contrast, it was noticeable how many heterosexual men from both the middle and the younger social generations had engaged in unprotected sex but had never been tested for STIs or HIV because they did not perceive themselves to be at risk. Pial, who had engaged in multi-partner sex reported never having been tested for STIs. He said that although he kept condoms ready, he occasionally did not use them when having sex outside his home. Moreover, he believed that his body was strong enough to withstand any diseases and therefore he felt reluctant to see a doctor.

Thus, cultural notions of good health and health risk, lojja or shame, a lack of health services for men, and the belief in a strong body could all influence men’s health- seeking. In addition, two of the same-sex attracted men recalled how they had been mistreated by doctors when they had sought help. They stated that when they had sought help from a hospital for mental health problems resulting from negative social attitudes and verbal abuse for their “feminine” behaviours, but doctors had advised them to mix with girls and had also prescribed medicines. They said that medicines prescribed by doctors produced no results. While having anal sex for the first time, Helal said that he had bled, but he had been too afraid to seek help because of doctors’ judgement regarding his engagement in same-sex sexual practices. He felt that it would be extremely difficult to make doctors understand about male-to-male sex because they would share the same heteronormative assumptions as other people in Bangladeshi society.

In summary, growing up in sexualised global cultures with access to education and modern technologies, the English-educated, relatively wealthy younger social generation men tended to be better informed than their older social generation counterparts about sexual health issues, although many were not familiar with the concept of “sexual health”. Issues of semen-loss, menstruation and avoiding sex after

136 childbirth rarely came up for discussions in interviews with the younger social generation men, perhaps because of changing beliefs and ideologies or because they (except for two men of this social generation) were yet to get married, start a family and become a father. Moreover, the accounts of younger social generation men’s help- seeking practices presented in this section indicated that they found it difficult to seek professional help because the Bangladeshi health system is organised without adequate sensitivity to younger men’s often more diverse sexual health needs.

Concluding remarks

It should be clear from the foregoing discussion that men’s help-seeking and information-gathering relating to sex is a gendered process mediated by the interplay among a number of religious, cultural, social, economic and technological factors. Findings suggest cultural beliefs about good health, belief in the Almighty, and the need to be a good Muslim strongly influenced both older and several of middle social generation men’s health information-seeking, health care and help-seeking practices. Men tend to adopt health beliefs and practices from culture that reflect their representation and enactment of gender (Saltonstall, 1993). As Courtney, (2000), has written, “Health-related beliefs and behaviours can […] be understood as a means of constructing or demonstrating gender. In this way, the health behaviours and beliefs that people adopt simultaneously define and enact representations of gender” (p. 1388).

This study revealed that older and middle social generation men, as well as a few younger social generation men, had sought little help for hardships in general, or for sexual health issues in particular. Most older social generation men had not even felt the need to seek help and information, believing themselves to be protected by Allah or God. In addition, cultural notions of lojja and their belief in having a “healthy” body (which was again rooted in cultural notions of “good” health) also discouraged them from seeking help. Moreover, successfully performing the hegemonic responsibilities associated with being a good provider for a family and being a good Muslim prevented middle social generation men in particular from seeking help and health care. Given their low income, low educational attainment, middle social generation men in this sample often found it difficult to seek help and health care. Thus, gender interacted with

137 the men’s income level, education and religion to influence their help and information- seeking.

The cultural association of lojja with pre-marital and extra-marital sex, and cultural taboos around sex more generally also discouraged and caused delay in help-seeking among both middle and younger social generation men. Yet middle social generation men displayed versatility in negotiating the hegemonic masculine codes that prevented them from help-seeking when they felt it necessary to protect the more important aspects of hegemonic masculinity, such as sexual prowess. This flexibility hints at the possibility of the reconfiguration of aspects of hegemonic masculinity.

The findings also highlight the relevance of modern information technology and education in influencing mainly English and/or private university-educated younger generation men’s sexual health-related help-seeking. Growing up in an “information age” or a “network society” (Castells, 2008, 2010) and being better connected than older men to a more sexualised global culture, enabled younger social generation men to utilise more diverse sources of information. They felt that the information and services they received from schools, from the Bangladesh-based mass media and from families were inadequate. In contrast, they found sources of information such as the Internet and friendship networks to be more realistic providers of information. This finding indicates that in Bangladesh, without the introduction of adequate sex and relationships education in schools, information and communication technologies may come to play an even more important role in the near future, both as a source of and a useful platform for sexual health information and advice for young people.

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Chapter 7: Rethinking masculinities/gender and men’s sexual health: A social generational perspective

Introduction

This study has sought to examine the implications of historically diverse and culturally specific masculinities for men’s sexual health in Bangladesh using a social generational perspective. Narratives from different social generations of Bangladeshi men were elicited through semi-structured interviews and analysed using a broadly abductive research strategy. Findings point to patterns in social generational masculinities, social generational sexualities, and health and help-seeking practices. They indicate both continuities and discontinuities, similarities and dissimilarities in meanings of masculinity and sexuality, and in sexual health and help-seeking practices. Taken together, the findings reinforce the need to move beyond reductionist, stereotypical and essentialist understandings of men, masculinities and gender in the South Asian context. In this chapter, I emphasise the usefulness of applying a social generational perspective to understanding masculinities and gender and to designing sexual health policies and programmes.

This chapter begins with a synthesis of principal findings, with an emphasis on contributions to new knowledge relevant to the South Asian context. It identifies and seeks to explain masculine ideologies and enactments of masculinities by situating these in a social generational and cultural context. Explanations for social generational continuities and discontinuities in masculinities, sexualities and help and health-seeking practices are offered and major findings are discussed in dialogue with key international and South Asian literature and theoretical frameworks employed. The strengths and limitations of the theoretical framework that informed the study are discussed. Informed both by the data and by the most recent theorising, I move beyond this framework to explore how masculinity/sexuality-assemblage theory may offer a useful way of bridging some of the limitations of Connell’s and Butler’s perspectives, as applied to the study of South Asian masculinities and sexuality. I do this by identifying different elements of the masculinity/sexuality-assemblage characteristics of each of the three social generations of men focused on and the implications of affective flows within each of these assemblages. I then consider the implications of these different

139 masculinity/sexuality-assemblages for health policy, programmes and further research, while acknowledging the limitations of this relatively small-scale study. Finally, the chapter concludes with some brief methodological reflections on the study itself.

Rethinking masculinities, gender and sexual health

This thesis has aimed to contribute to the existing masculinities and sexual health literature by offering a more socially and culturally located understanding of masculinities, sexuality and sexual health than hitherto described, for three social generations of Bangladeshi men. Research to date has shown that masculinities and sexualities are shaped by class, gender, ethnicity and race (Pyke, 1999; Messerschmidt, 1993; Connell, 1995, 2000; Srivastava, 2004a; Seidman, 2015). However, relatively little international research to date has explored how social generations can be an important axis around which masculinities are constructed and sexual lives lived and negotiated (Plummer, 2010).

Continuities and discontinuities across social generations

Much of the available literature on men’s sexual and/or reproductive health in South Asia has focused on difficulties and embarrassments, such as dhat syndrome, men as barriers to women’s reproductive health, and sexual practices among same-sex-attracted men as well as other multi-partnered risk groups such as long-distance truck drivers (Rao, Nag, Mishra, & Day, 1994; Khan, 1997, 2004; Majumder, 1999; Alam, 2010). In perhaps the majority of these studies, men tend to figure as overly homogeneous, essentially biological categories, not as gendered subjects or as members of distinct social generations. Although some important research has been conducted on young men’s masculinities and sexual practices in Dhaka (Muna, 2005; Imtiaz, 2012) and on changing gender norms among young men in India (Verma et al., 2006), none of the published studies has adopted an explicitly social generational approach.

Applying a cross-sectional design and Mannheim’s theory of social generations in this study allowed me to develop novel insights into how men of different social generations enact and negotiate multiple forms of masculinity. As elaborated below, the study revealed that meanings of masculinity and sexual practices showed similarities yet differed across the three social generations. Importantly, there were few significant

140 social generational differences with respect to certain ideals of masculinity. Men from all three social generations understood masculinity in terms of power, money, sexual prowess, being a good “provider”, being independent, and having regular paid work outside the home. Previous research in India (Staples, 2011) and in Bangladesh (Muna, 2005, pp. 17-21) similarly reports these to be important constitutive elements of South Asian masculinity. Muna (2005), for example, found that both young men and women in Dhaka valued traditional masculine characteristics such as courage, confidence, strength, a sense of power and the ability to provide for the family (p. 20). Imtiaz (2012), researching the sexual practices of young men in Dhaka, suggested that sexual achievement, power and money were key dimensions of being a sofol purush (a successful man), a view which embodies a hegemonic model of masculinity. For all three social generations of men in this study, hegemonic masculinity with the characteristics described above was embodied in being a sottikarer purush (a real man).

In addition, there were similarities across social generations in sexual practices and health and help-seeking practices. Not engaging in kharap kaaj (i.e., sex before or outside marriage) was a common practice among both older and most middle social generation men. However, men of the younger social generation differed from their older counterparts in terms of their engagement in pre-marital sex, although a few of them reported not having done so. Men from all social generations reported not seeking health care or help for many of the health problems they had encountered. Moreover, older and middle social generation men relied on traditional sources for health information, indicating some social generational similarities between them in health and help-seeking practices.

Some explanations for these similarities and a certain stability in the construction of masculinities across social generations can be offered, drawing upon Mannheim (1952) and Plummer (2010). For Mannheim, older generations create the social worlds with which a new generation makes “fresh contact”, and therefore each generation influences other generations. By the term fresh contact, Mannheim meant “meeting something anew” (p. 293). As he observed, “Generations are in a constant state of interactions” (p. 301). In this study, although men of a particular generation were born into different historical, social, economic and political contexts, they did not grow up in isolation from other social generations. Each social generation interacted with the others and thus

141 influenced, at least in part, ideas of masculinity and sexual practices. For Mannheim (1952), societies tend to have “the necessity for the constant transmission of the cultural heritage … the most important aspect of which is the automatic passing on to the new generations of the traditional ways of life, feelings, and attitudes” (p. 299). This continuity implies that there may be some ideologies (of gender in this case) that are so powerful as to be resistant to change and which are reproduced over time, and hence across social generations.

Such a view was partly borne out by findings from this study, which revealed social generational similarities in sexual practices, especially between older and middle social generation men (key differences are discussed below). Plummer (2010) has made the point that human sexual lives are cumulative and that past sexual histories can have an effect on the present. Regarding social generational similarities in sexual practices, he wrote, “Human sexualities accumulate across a life – they leave sexual stains, sexual traces, sexual sediments. Any contemporary moments will always have traces of the sexual past” (p. 181, original emphasis). He adds, “the massively differentiated generational pasts are bubbling in the here and now” (Plummer, 2010, p. 188). Older social generation men and most middle social generation men organised their sexual lives around marriage and according to what they perceived to be as the dominant codes of Islam. This stability signals the presence of some important cross-generational similarities.

Just as there were similarities, there were also notable differences among social generations in terms of ideas of masculinity, sexual practices, and health and help- seeking practices. Findings presented in previous chapters indicate that men of different social generations tended to differ from one another in terms of religious beliefs and practices, the meanings attached to sottikarer purush (real men), attitudes towards sex, work aspirations, and sources of and knowledge about sexual health. These differences were starkest between the oldest and the youngest social generations and can be linked to the different historic, social and economic circumstances in which these social generations live. The more dissimilar the historical periods and social experiences social generations live through, the more different social generational masculinities and social generational sexualities are likely to be.

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Findings also suggest, however, that social generations are not homogeneous. In this study, there were noticeable intra-generational differences in notions of manhood, in sexual practices and in help-seeking and health-seeking practices. This echoes elements of Mannheim’s (1952) theory, which recognised both homogeneity and heterogeneity between and among members of a social generation. He used the concept of “generation units” to refer to intra-generational heterogeneity. Findings from the present study suggest that, in spite of their common generational location or Lagerun, members of a social generation tended to have access to different forms of social, economic and cultural capital, which work together to produce what Mannheim (1952) called generation units. Although men in this study occupied the same generational location, all the men of the same social generation were not a “generation in actuality” (Mannheim, 1952, p. 304). Social inequalities that increase in the context of economic transformation and globalisation may have contributed to these intra-generational differences.

Mannheim (1952) conceived of generations as nationally bounded social categories. However, the narratives of younger social generation men in this study underscore the need to consider social generations beyond national boundaries because in an age of globalisation, historical events are experienced globally and thus people may develop elements of global, as well as local, generational consciousness. Edmunds and Turner (2005) have said that the new social media play a pivotal role in the formation of a global generation or global generational consciousness. Younger men’s narratives in this study signal the important role of such media in the production of new masculine ideologies and in influencing sexual practices as well as health information-seeking.

Masculine ideologies and practices can in part be reconfigured by processes of economic globalisation, cultural globalisation, access to technology and educational opportunities. In Mannheim’s (1952) view, social and historical transformations can bring about changes in attitudes, practices and thoughts among the people who experience these shifts (p. 294). Engagement in pre-marital sex by younger social generation men and the emergence of non-normative gender identities among same-sex attracted men of this same social generation pointed to instabilities in traditional masculine ideologies in a conservative, Islamic cultural context such as Bangladesh.

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Ritzer (1993) argued that globalisation has contributed to greater similarities in cultural expression across the world – via a process, which he called “the McDonaldization of society”. In this study, and in line with Ritzer’s thesis, younger men’s lives, ideas, and sexual practices reflected an increasing Westernisation of local culture in settings such as Bangladesh. Several younger social generation men embraced neoliberal ideas of freedom, personal choice and success in life by desiring or seeking to take up upper middle class jobs. Mannheim (1952) said that the quicker the “tempo of change”, the more intense the discontinuities that result from the change (p. 310). In this study, the tempo of change was so rapid that some younger social generation men had developed a new generational style through coming into fresh contact with new technologies, social media, and opportunities for higher education and so on (Mannheim, 1952; Edmunds & Turner, 2005).

Gender, masculinities and power

Connell’s work on masculinities and gender illuminates and is supportive of the findings in this thesis in a number of ways. Her theory of masculinity suggests that masculinities arise and take shape at different historic periods and in multiple institutional sites characterised by gender hierarchy and unequal power relations. In this study, the inter-generational and intra-generational differences in masculinities described suggest that there is no single Bangladeshi or South Asian masculinity. Men’s articulation of different forms of masculinity was indeed shaped by structural factors such as unequal power relations, class inequality and a gendered division of labour. Previous research in mainly Western contexts has suggested that men from lower classes tend to engage in excessive drinking, speeding, fighting and blue-collar jobs in order to articulate their masculinity (Connell, 1991, 2000, 2005). However, in settings such as Bangladesh, lower class men may not engage in overt forms of violence because they have little social, economic, and political power to deal with the possible repercussions of such behaviour. In contrast, some upper class men (who are more able to negotiate successfully the police and criminal justice systems) may perpetrate violence and engage in drinking, fighting and similar practices.

Connell’s work is also helpful in moving beyond the stereotypical understandings of men, masculinities and gender often found in the South Asian sexual health research

144 literature. Within this literature, and until this point, men have appeared largely as risk- takers, as violent, as uncooperative and as barriers to health promotion (for example, Alam, 2010; Anwary, 2015). In contrast, my research found elements of a caring masculinity among some study participants, in the form of older and middle social generation men, who rejected domination and embraced values of care more usually associated with femininity (Elliot, 2016). Both older and middle social generation men in this study cared for their families and for themselves by working hard. They reported that they had not wanted to cause any julm (harm) to their wives and had not engaged in violence, which offers an indication of their enactment of caring masculinities. More generally, Barker et al. (2012) offered examples from around the world of men’s caring masculinities.

Connell’s theoretical framework was also useful in exploring the hierarchy of masculinities in a South Asian context. The notion of hegemonic masculinity is one of the most important concepts developed by Connell (1987) and has been widely used by other masculinities researchers (Messerschmitt, 1993; Sabo & Gordon, 1995; Noone & Stephens, 2008). Connell suggested that hegemonic masculinity is organised as an admired, culturally exalted way of being a man, but one which most men cannot live up to. A variety of other forms of masculinity exist (such as complicit masculinity and subordinate masculinity), based on some men’s acceptance of gender inequality and their subordination respectively (Connell, 1995). Examples cited in the findings chapters (chapter 4) indicate that participants did indeed perceive there to be hierarchies between men based on factors such as age, sex, power, money, sexual prowess, class, education, occupational status, marital status, access to technology and fatherhood.

Finally, the present study indicates that the hierarchical nature of masculinity can have real consequences for men’s social and sexual lives. While married men who were able to display sexual success within marriage provided a model of hegemonic masculinity, same-sex-attracted men and men with sexual health problems (such as dhojovongho) were not seen as sottikarer purush, suggestive of the way in which masculinities were hierarchically organised (Connell, 1987, 1995; Connell & Messerschmidt, 2005). Additionally, same-sex-attracted men reported experiences of verbal and physical abuse and of needing to lead a double life, reflecting the effects of the dominant hetero- patriarchy characteristic of Bangladeshi society.

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Gender, masculinities and performativity

In contrast to the categorical understandings of gender provided by sex role theory, Butler (1990) sought to re-theorise gender as performativity. Men’s performativity in this study entailed a range of practices, including manly ways of acting, walking, talking, earning money, providing maintenance, getting into fights and being sexually successful. There were social generational differences and similarities in these practices. While narratives suggest that men of older and middle social generation sought to enact gender through various forms of heterosexual prowess, younger social generation men revealed enacting gender through manly styles of talking, bodily comportment and so on. Butler (1990) has described these gendered practices (that is, ways of acting) as the “stylized repetition of acts” that constitute gendered subjects (p. 141, original emphasis). Moreover, same-same-attracted men’s enactment of both masculinity and femininity clearly highlight the performative aspects of gender in the South Asian context. Thus, findings reveal how performative actions bring into being the ideas of masculinity and gender (Butler, 1990, 1993).

Importantly, Butler’s theoretical framework offers opportunities to develop an anti- essentialist perspective on men, gender and masculinities. This theoretical lens helps us understand men as gendered beings in the making. In the South Asian context, gender has too often been conflated overly simplistically with women (Fikree & Pasha, 2004; Cockcroft, Pearson, Hamel, & Andersson, 2011; Hossain, 2003). This thesis offers an account of how men of different social generations negotiated gendered and variously sexualised identities in multiple sites and at different times and settings. To date, there has been little evidence of the use of such a perspective in the South Asian and Bangladeshi literature where masculinities and femininities remain largely seen as unchanging traits inherited by men and women (Hasan, Aggleton, & Persson, 2015). The use of Butler’s theory allowed me to move the analysis beyond the narrow understandings provided by these and other similarly static accounts.

In particular, Butler’s concept of performativity proved useful in examining effects linked to the social regulation of sexuality in the Bangladeshi context. In her writing, Butler draws an important distinction between performance and performativity. While the term “performance” implies doing or enactment, performativity points to the power

146 of regulatory discourses, power relations and their effects (Butler, 1996, as cited in Brickell, 2005, p. 28). Using notions of performativity, it has been suggested that “masculinities appear within language and society as [the] effects of norms and power relations rather than pre-social biological essences” (Brickell, 2005, p. 29). In this study, regulatory gender norms linked to religion, culture and law strongly affected men’s sexual lives. The discursive association of pre-marital sex with kharap kaaj (bad work), the notion of pobitrota (purity) in romantic relationships, and the association of same- sex sexual practices with haram (the forbidden) or the “unnatural”, were just some of the regulatory discourses that affected study participants’ enactment of different forms of masculinity.

Finally, just as Connell’s theory helped me to look at the hierarchical nature of masculinities, Butler’s (1990) idea of the heterosexual matrix proved useful in examining gender and sexual relations within the South Asian context. Butler’s notion of heterosexual matrix is somewhat similar to Connell’s concept of hegemonic masculinity. For Butler (1990), the production of the “heterosexual matrix” is critical to the gender division itself. She used the term “to designate that grid of cultural intelligibility through which bodies, gender, and desires are naturalized” (p. 151) in such a way that hegemonic heterosexuality becomes the dominant norm through which all other sexualities are defined. Butler (1990) argues that heterosexuality is erroneously constituted as the “original” form of sexuality, and homosexuality as a “copy”. She emphasises that there is indeed no original, but merely the idea of the original (Butler, 1990; Brickell, 2005, p 32). In the Bangladeshi or the South Asian context, as this study suggests, there exists a marital heterosexual matrix because most men, especially from the older social generations, took for granted heterosexual marriage as the norm or the “original”. In contrast to some Western contexts, sexuality is more strictly regulated in South Asia, with sex expected to occur within marriage and between members of the opposite sex. As men’s narratives in this study indicated, powerful discourses about sexuality and gender produce the marital heterosexual matrix. However, subversion sometimes occurs through engagement in pre-marital sex by younger and some middle social generation men, and through the enactment of femininity by same-sex-attracted younger social generation men.

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Despite the strengths of Connell’s and Butler’s theoretical frameworks, when it comes to understanding masculinities in the South Asian context, their theories leave some issues unaddressed, as they were first developed within a very different social context. Although both authors drew attention to the locatedness, multiplicity and the performative aspects of gender and masculinities, they did not engage explicitly with the notion of social generations, which draws attention to the temporality of masculinities. Throughout this thesis, I have sought to demonstrate how performative acts (Butler, 1990) and multiple masculinities (Connell, 1995) are profoundly generational in character in the South Asian context, thus adding a new dimension to the theoretical models employed to date.

In addition, while Connell discussed several structures within which masculinities take shape and are reshaped by agency, Butler’s work carries with it a poststructuralist orientation emphasising how powerful discourses and the heterosexual matrix bring into being gender identities. In contrast to more recent work, Connell’s and Butler’s theories of gender and sexuality have relatively little to say about how ideas, “things”, and social institutions come together to co-produce the affective flows characteristics of what have been called sexuality-assemblages (Fox & Alldred, 2013). Alldred and Fox’s (2015) recent work on the sexuality-assemblages of men, as discussed below, may offer a more useful framework in making sense of these aspects of sexuality and masculinity both contemporaneously and from a social generational perspective.

The masculinity/sexuality-assemblages of different social generations

In their recent writing, Alldred and Fox (2015) emphasise the need to approach sexuality as an assemblage of “multiple bodies, things, ideas and social formations that cut across cultural and natural realms” (p. 907). Sexuality-assemblage theory shifts the focus away from human agency to the Spinozist notion of affect, which means “the capacity to affect or be affected” (Fox & Alldred, 2015, p. 401). Flows of affect are produced within these assemblages, which enable or limit capacities within a body or bodies to act, desire and feel. Inspired by Deleuze’s and Guattari’s (1984, 1988, as cited in Fox & Alldred, 2013, 2015) philosophy of assemblage, this perspective sees sexual desire as a creative capacity, not as an unmet need to be fulfilled. In such a view, “there are no boundaries to human sexuality” (Deleuze & Guattari, 1984, as cited in Fox &

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Alldred, 2013, p. 784). The body is not seen as a repertoire of desires. Critically, this theoretical perspective places emphasis on what a body can become, instead of what a body is. Sexuality-assemblage theory, as proposed by Alldred and Fox (2015), thereby shifts the focus away from identities and individuals to relations and affects within the assemblage of bodies, things, ideas and social institutions. This theory is in contrast to theories in which “desires, attractions and sexual behaviours are individualised, to be studied as attributes of speciﬁc human bodies, and constitutive of (individual) human subjects” (Alldred & Fox, 2015, p. 906). Crucially, this perspective moves beyond distinctions between agency and structure, mind and matter, micro and macro levels of analysis, dissolving the dualisms between the private and the public, and between nature and nurture in the social sciences.

Again, drawing on concepts developed by Deleuze and Guattari, Fox and Alldred (2015) outline a distinction between “territorialisation” and “deterritorialisation”, which both characterise an assemblage. Territorialisation describes how well defined the identity of an assemblage is (DeLanda, 2012). It occurs when “affects deriving from relations in assemblages specify or ‘localise’ the capacities of a body or other relations” (Alldred & Fox, 2015, p. 909). In contrast, deterritorialisation may occur if an assemblage is flexible enough to change, and instead of limiting existing capacities, allows for the production of new ones. Affects can be either singular or aggregative. “Singular affects may be micropolitical drivers of de-territorialisation, enabling bodies to resist aggregating or constraining forces, and opening up new capacities to act, feel or desire” (Alldred & Fox, 2015, p. 909). In contrast, aggregative affects act to create convergence, stabilities, and set limits on bodily capacities. While singular affects (such as a caress or a kiss) may produce discontinuities within an assemblage, aggregative affects (such as a sexual code of conduct) tend to produce stabilities within an assemblage (Alldred & Fox, 2015). Singular affects may occasionally deterritorialise an assemblage, thus producing “lines of flight”, ruptures and discontinuities (Fox & Alldred, 2015, p. 402). The term “line of flight” was used by Deleuze and Guattari (1987) to denote the possibility of escape or the moment when change happens within an assemblage (as cited in Fournier, 2014, p. 121).

Assemblage theory (outlined above) allows for a slightly different interpretation of study findings, taking into account the relations between and among the different

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elements that comprise the masculinity/sexuality assemblage of different social generations of men. Looking at the study findings from this perspective, different elements comprise the masculinity/sexuality-assemblage of different social generations of men (see table 1). For members of the oldest social generation, wives, marriage, traditional ideas (about semen, menstruation, pregnancy, birth, and manhood, etc.), strict codes of sexual conduct, rural physical spaces, prayers and sexual prowess, for instance, appear as key elements within the masculinity/sexuality-assemblage.

By contrast, the masculinity/sexuality-assemblage of younger social generation was significantly different despite there being certain residual similarities. It encompassed, among other features, city spaces, technology, mobile phones, parents and neighbourhoods, neoliberal ideas, the Internet, girlfriends, friends, condoms, social media and sexuality information. Middle social generation men’s masculinity/sexuality- assemblage included many elements of both older and younger social generation men’s assemblages.

Table 1: The masculinity/sexuality-assemblages of different social generations Social Masculinity/Sexuality- Affective Flows Capacities Generation Assemblage Produced within the Produced by Masculinity/sexuality- These Affective Assemblage Flows

Oldest Traditional social norms, Aggregative affects in a Male bodies can sexual norms, rural space highly restrictive sexual have sex with and samaj (society), environment. Love women within wives, religion, gender develops and sex takes heterosexual segregation, Islam, early place after marriage. marriage, the marriage, fathers, food, assemblage medicines, lack of formal territorialises education, traditional sexual desires ideas (e.g., about before or outside menstruation, sex, marriage and semen), physical between men, but weakness, disease and some slippages sickness. may occasionally occur due to singular affects.

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Middle Friends, wives, sex Aggregative affects in a Aggregative workers, male friends restrictive sexual affects produce and homosocial bonds, environment. Love stability in premikas (girlfriends), develops before notions of urban physical space, marriage, but sex masculinity and samaj, religion, Islam, happens after marriage. in sexual masculine ideologies, Singular affects may practices. notion of pobitrota produce ruptures within However, the (purity) in romantic the assemblage of relationships, marriage, masculinity/sexuality- homosocial television, traditional assemblage (e.g., sex bonds, urban ideas (e.g., about with sex workers or sex space and sex menstruation, sex, semen outside marriage). workers produces etc.), workplaces, singular affects poverty. creating possibilities for deterritorialisation within the assemblage.

Youngest Friends, girlfriends, sex Both aggregative and Bodies can desire workers, city life, sexual singular affective flows. sexy bodies norms, Western notions Love develops and secretly in urban of love, sanctions on pre- secret sex may take spaces. Singular marital sex, higher place before marriage. affects produce education, critical Restrictive sexual discontinuities thinking, analytical environment in spite of and ruptures, thus abilities, sexual greater opportunities to producing a line attractiveness, parents meet sexual partners. of flight (e.g., and neighbours, pre-marital sex, electronic media, same-sex sexual technology, social media, encounters). At mobile phones, global the same time, norms and values, aggregative pornography, condom, affects attempt to neoliberal values of reterritorialise the personal choice and masculinity/sexua freedom etc. -lity-assemblage.

Table 1 above shows in summary form the masculinity/sexuality-assemblage of different social generations, the kinds of affective flows that are produced within assemblages, and the capacities that are produced within bodies as a consequence. It highlights how different elements configure masculinity/sexuality-assemblages at different times and points to both similarities and dissimilarities in key elements and affective flows across the social generations. These assemblages allow both for social

151 generational differences and similarities in the masculinity/sexuality-assemblages and in the affective flows produced within these assemblages.

The table further suggests that the assemblage of religion, marriage, ideas about menstruation or semen-loss and so forth set limits on bodies’ capacities to feel and desire before/outside of marriage. In contrast, singular affective flows produced within the masculinity/sexuality-assemblage of urban physical space, mobility, neoliberal values of personal choice and freedom, and Western ideas of love deterritorialise older forms of masculinity/sexuality-assemblage, creating possibilities for “a line of flight, ruptures and discontinuities” towards different forms of lifestyles, sexual capacities and sometimes new forms of gender identities.

In the present study, territorialisation resulted in relatively limited social and sexual capacities among older social generation men (Alldred & Fox, 2015, p. 912), aggregating their sexualities into compulsory marital heterosexuality and forms of hegemonic Islamic masculinity. For middle social generation men, almost the same territorialisation occurred, but for some men of this generation deterritorialisation also occurred. While Islamic codes of social and sexual conduct, samaj and so on territorialised the oldest social generation men’s sexual expressions within marriage, the reassembling of middle social generation men’s masculinity/sexuality-assemblage, encompassing urban space, migration, and homosocial bonds, occasionally deterritorialised the assemblage – resulting in engagement in urban employment, and sex with sex workers. This remaking of the masculinity/sexuality-assemblage was particularly profound for middle social generation men who had experience of rural-to- urban migration and who worked in urban factories and/or in the urban informal sectors. For them, homosocial bonds, greater opportunity to meet sexual partners and the ready availability of sex workers in places such as hotels, parks and other meeting places triggered a significant deterritorialisation. At the same time, the masculinity/sexuality- assemblage of other middle generation men (who had not had quite these same experiences) remained as territorialised as that of their older counterparts.

As the masculinity/sexuality-assemblage of the youngest social generation men appears relatively deterritorialised compared to that of their older counterparts, it is associated with different and new social and sexual capacities. Their assemblage (see table 1) is

152 characterised by the adoption of urban lifestyles, pre-marital cross-sex mixing, and pre- marital sex. Their assemblage of girlfriends, restaurants in cities, ideas of love and personal choice produced capacities for “making out” (or non-penetrative sex), albeit secretly. However, the counter-assemblage of older people, parents, neighbours and strict codes of life (including sexual life) often sought to reterritorialise youngest social generation men’s masculinity/sexuality-assemblage.

The constitution of homosexuality as a sin, haram or unnatural, territorialised affective flows produced within the assemblages of all three social generations studied. For only a few men of the youngest social generation, the masculinity/sexuality assemblage, which encompassed same-sex-attracted men’s networks both online and offline (along with higher education and ideas of sexual rights), triggered deterritorialisation and the possibility of new sexual and other capacities and subjectivities. The emergence of new forms of non-normative gender identities (e.g., gay-like identities) among some such men hints at such a deterritorialisation.

The masculinity/sexuality-assemblages described above are not deterministic because continuing processes of territorialisation, deterritorialisation and re-territorialisation may produce new lines of flight, tensions, and contradictions, which may intensify in the context of accelerated but contradictory processes of globalisation and localisation, Islamisation and secularisation, in settings such as Bangladesh. Differences in sexual practices between and among the social generations, the emergence of new subjectivities, engagement in pre-marital sex by younger social generation men and moral anxiety about this among older social generation men, debates about same-sex relations, the reading-down of the IPC section 37721 (that is, the clause is no longer in effect), and then the reversal of this decision by the Supreme Court of India when it recriminalised homosexuality (Boyce, 2014), all indicate the working through of some of these tensions and contradictions within the South Asian context.

21 IPC stands for the Indian Penal Code introduced in 1860. The relevant section mentioned here criminalised certain sexual acts which were described as “acts against the order of nature” (Boyce & Khanna, 2011; Boyce, 2014).

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Implications of masculinity/sexuality-assemblages for men’s sexual health

Previous research has drawn attention to some of the “toxic” or negative consequences of dominant norms of masculinity in the form of high male mortality from risk-taking, accidents, mental health problems and suicide (Connell, 2000; Courtenay, 2000a). Research also indicates that men generally tend to under-utilise health care in order to avoid dealing with their vulnerability (Tannenbaum & Frank, 2011, p. 241), that men do not get in touch with their feelings and that they are often late to seek help (Helgeson, 1995; Addis & Mahalik, 2003). By contrast, more recent work by Snipes et al. (2015) has argued that concerns for work and family can motivate men to engage in healthy behaviours, which may have positive health consequences. In another study, older rural men in New Zealand positioned themselves as “knowledgeable and legitimate health care users” in contrast to other “ignorant” or “weak” men who did not use health care (Noone & Stephens, 2008).

The present study highlights not only some of these negative effects but also some of the more positive aspects of men’s enactment of masculinity. Flows of affect produced within the masculinity/sexuality-assemblage of the older and most middle social generation men produced the capacity not to engage in risky sexual practices (e.g., by not having sex with multiple partners). Additionally, the masculinity/sexuality- assemblage of some younger social generation men provided opportunities for new learning about STIs, condom, HIV and AIDS, which was different from the behaviours of older social generation men who felt no or little need to know about STIs, HIV and AIDS, and sexual health. Finally, some middle social generation men were found to prioritise their wives’ and children’s health needs over their own, thereby enacting a caring masculinity (Elliot, 2016) with positive health consequences for their families, but negative health outcomes for some of the men themselves when they did not seek help for their own health problems.

In contrast, findings suggest that dominant notions of hegemonic masculinity can negatively affect sexual health. As indicated in the previous section, the masculinity/sexuality-assemblages of different social generations tend to set limits on bodily capacities and the aggregative flows associated with particular masculinity/sexuality-assemblages can set limits on possibilities for sexual expression.

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In particular, men’s adherence to Islamic and social norms and heteronormative codes may curtail pre-marital and non-heterosexual forms of sexual expression. Middle social generation men’s feelings of fear linked to their engagement in pre-marital sex and experiences of unfulfilled sexual desires (shihoron) before marriage, and some younger social generation men’s experiences of abuse for being kothi or gay, reported in chapter 5, support this claim.

While the masculinity/sexuality-assemblages of the oldest and middle social generations may work to reduce certain sexual health risks, they also produce limited sexual and other capacities. In particular, these assemblages provide little or no opportunity to know about sexual health in the sense “a state of physical, mental and social well- being” (WHO, 2010, p. 3) in all matters relating to sexuality. In particular, the oldest social generation men’s masculinity/sexuality-assemblage, which comprised samaj (society), religious beliefs and ideas and traditional sources of information accessed through older men, facilitated little in-depth appreciation of sexual health as a broad- based state of becoming or being.

The inclusion of heterosexual prowess as a constitutive element of masculinity/sexuality assemblages has implications for both men’s and women’s health. Findings from this study suggest that being able to satisfy sexually one’s female partner was an important dimension of masculinity for many men. Likewise, research in India suggests that sexual potency (or the capacity to father children and to satisfy a woman sexually), responsible fatherhood and decision-making power as head of the family, are seen as manly attributes (Osella & Osella, 2006; Staples, 2011). The construction of heterosexual prowess as a key characteristic of sottikarer purush (real men) and some men’s inability to fit into this model of masculinity can evoke feelings of lojja (shame), embarrassment, frustration and anxiety. In South Asian contexts, where sexual potency is viewed as a hegemonic characteristic, men who have not engaged in sex before marriage may suffer from “first-night anxiety” and the fear of not being sexual successful after marriage (Osella & Osella, 2006). In this study, old age, weakness, sickness, disease, lack of sexual experience, and erectile dysfunction (or dhojovongo rog) also posed challenges to men’s sense of sexual prowess and affected their understandings of themselves as sottikarer purush. Thus, men’s sexual health problems appear intimately linked to the construction of prowess as an element of the

155 masculinity/sexuality-assemblage. Interestingly, the finding that men attempt to satisfy their wives sexually (in order to demonstrate their own sexual prowess and/or their commitment to their wives’ pleasure), runs counter to the claim that Bangladeshi men think only about their own sexual pleasure. For example, both Arens and van Buerden (1980) and Imtiaz (2012) suggest that Bangladeshi men play an active, dominant role in the arena of sexuality but care only for their own sexual pleasure. Khan (2004) also argued that gender inequality between men and women in Bangladesh undermines women’s sexual rights, pleasure and equality in relationships. In a similar vein, Imtiaz (2012) writes, “In case of sexual act with a female, it is only the male pleasure that counts and they adopt all kinds of techniques to maximise this, including physical abuse, avoiding condoms, etc.” (p. 128). In contrast to these claims, findings from the present study suggest that some men (of all generations) may be concerned to please their female partners, thus enacting a rather different form of “caring” masculinity to the dominant forms so far reported in the existing literature.

Study findings also suggest that certain elements within men’s masculinity/sexuality assemblages, such as independence, strength, power, courage, breadwinner ideologies, ideas about “good” health, and cultural notions of lojja (shame) associated with sex and sexual organs, may be linked to men’s help and health-seeking practices. As discussed in chapter 6, these elements limit the capacity of men from all three social generations to seek out help for sexual health problems in a timely way. Linked to this, findings suggest that the masculinity/sexuality-assemblages of some middle and younger social generation men may produce some sexual health risks. Their masculinity/sexuality- assemblages, which included friends, casual sexual partners, sex workers and urban physical spaces such as hotels and parks may allow for new opportunities, with concomitant sexual health risks. This potential sexual risk was reflected in some middle and younger social generation men’s accounts of having contracted juana rog (STIs), as the result of their engagement in different forms of commercial sex.

Overall, findings suggest that the different masculinity/sexuality-assemblages documented in this study carry with them both positive and negative health consequences. These findings challenge research that links masculinity solely to sexual health problems. While the assemblage of the strict code of social and sexual lives produces fewer sexual health risks linked to early initiation into sexual life, or sex with

156 multiple partners, the same assemblage constrains gender and sexual capacities. By contrast, more recent assemblages, which include elements such as sex workers, urban spaces, hotels, homosocial bonds and so forth, are associated with negative health effects, especially for some middle and younger social generation men.

Promoting sexual health

Over the last 20 years, there has been a growing emphasis on working with boys and men to address harmful effects of masculinity in relation to violence, and men’s own health (Barker & Das, 2004; Wu, 2011; Promundo, UNFPA, & MenEngage, 2010; Gibbs, Vaughan, & Aggleton, 2015). This study was exploratory in nature and thus did not aim to develop specific recommendations for policy and practice. Nevertheless, the construction and enactment of masculinities across multiple institutional sites do have important implications for men’s health and for future health policy and practice. Based on the findings presented and conclusions drawn, I would like to highlight three important points that may be considered when thinking about future policy and designing programmes for health or sexual health promotion. These points are firstly, the recognition of multiple masculinities; secondly, the need to take social generations seriously; and finally, the value of working with masculinity/sexuality-assemblages. It goes without saying that study findings indicate that masculinities are multiple, variable and show change. The thesis underscores (in an under-researched context) the need to move beyond essentialist, reductionist, categorical and stereotypical understandings of men, masculinity and gender in the South Asian context and the importance of recognising the multiplicity, temporality and performative nature of gender relations.

Moreover, it is useful to appreciate the positive roles that men can play in health promotion, recognising both the positive and negative effects of men’s enactment of masculinities and gender. Instead of seeing men only as barriers and risk-takers, we can more productively view men as gendered beings and as agents of change, who have the potential to subvert dominant norms of gender and masculinity through performative acts. Men in this study enacted caring masculinities, non-violent masculinities and forms of Islamic masculinity that carried with them benefits for both men and women. The multiplicity and variability of enactments suggest it may be possible to reconfigure some of the more “toxic” masculinities that may have negative health consequences.

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However, social generational stability in gender norms (the sexual division of labour within the home, men’s provider role, their desire for independence, etc.) may make this a challenging task to accomplish given the constraints of hegemonic masculinity.

Secondly, study findings underscore the need to take social generations seriously when designing policy and practice for sexual health promotion. They suggest the need to develop more generationally sensitive health programmes and policies. To date, health programmes and policies have paid little or no attention to social generations. This study identified important social generational differences (despite certain similarities) in sexual practices, ideals of masculinity, and help and health-seeking practices. These differences imply that members of different social generations face different health problems, have different health needs, and may benefit from different health promotion interventions and activities. Social generational differences were especially noticeable in terms of the sources and types of sexuality information accessed and received. While men of the oldest social generation relied mainly on traditional sources, men of the middle social generation drew on both traditional and modern sources, and younger social generation men utilised newer technologies such as the Internet. Therefore, the same health/sexual health-promotion approaches, strategies and programmes may not be suitable for all social generations of men. For younger social generation men, in particular, information and services can perhaps be more effectively disseminated electronically and through the social media. For middle social generation men, more conventional methods such as peers, radio and television may prove more effective.

Finally, it is important to pay careful attention to masculinity/sexuality-assemblages, described in the previous section. As the elements that comprise the masculinity/sexuality-assemblage tend to differ from one generation to the next, programmes and policies will be more productive if they are cognisant of differences and similarities in the elements of masculinity/sexuality-assemblages and identify which elements within each assemblage can best be used to promote health, and which elements may be detrimental to sexual health. It is also critical to recognise that the continuous process of territorialisation, deterritorialisation and reterritorialisation (described above) may produce new lines of flight within the assemblage, such as new forms of subjectivity or new forms of health-seeking practice, creating both opportunities and challenges for sexual health promotion.

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Future research

It is important to recognise that the findings presented and conclusions drawn in this thesis are based on men’s accounts provided within a particular social context and accessed using particular research methods. The accounts were generated in a social setting where religious codes and cultural norms about sexuality make it difficult to discuss many topics openly.

Indeed, the domain of sexuality is considered to be so private in Bangladesh that it can often be difficult to talk about even culturally normative forms of sexuality. Therefore, there are few ways of validating the information that men provided during interviews. Although men’s narratives in this study offer novel insights into social generational masculinities and sexualities, it is critical to acknowledge that their accounts were performative in the sense that men often appeared to present themselves as “good” Muslim men by reporting adherence to dominant norms of masculinity, sexuality and gender. Moreover, there was little observational evidence of men’s gendered practices in relation to help and health-seeking and the enactment of masculinities. Combining ethnographic approaches, including participant observation with semi-structured interviews, could help to triangulate the claims men made in this study. Unfortunately, the study design and time constraints made this approach impossible, but it remains as a priority for future research.

In terms of study design, the cross-sectional approach aimed to produce men’s narratives from three social generations at one point in time. It was not possible to collect narratives from the different social generations at different moments due to time constraints. Because of this constraint, older men had to rely on their long-term memory to talk about events that had happened long ago. Many did not know exactly how old they were. Older social generation men’s reliance on distant memories and middle social generation men’s needs to think back a few years prevented the development of a properly historical understanding. Applying a longitudinal study design and collecting data from social generations at different points in time could help to produce more nuanced, historically located understandings of social generational masculinities, social generational sexualities and help and health-seeking practices. This kind of enquiry could usefully be pursued in later work.

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It would also be interesting to expand upon this enquiry by eliciting the views of comparable samples of Hindu, Muslim and Buddhist men and men who do not ascribe to any religion. There is a small but increasing and influential number of Bangladeshi young men who profess to be progotishil (progressive). Some have written blogs that are critical of Islam. Some orthodox Islamic political parties have described them as nastik (or atheists). Since February 2013, a number of young male nastik bloggers have been killed allegedly by radical Islamic groups (The New York Times, May 8, 2016). What might their views on masculinity be like, and how might their masculinity/sexuality-assemblages differ, if at all from those of their contemporaries? Similarly, there is scope for studies of rural men who still comprise the large majority of the Bangladeshi society and minority ethnic men22 who may enact very different masculinities.

This research was specifically about men’s perspectives of masculinity and did not focus on women’s notions of masculinity and femininity, the inclusion of which could cast further interesting light on gender in future research in Bangladesh. Connell (1995) argued that masculinities arise in the context of gender relations. The absence of women’s accounts with respect to gender relations, masculinity and femininity in this study is a weakness, and future research will be valuable in showing how women themselves play a role in the production of masculinities and/or perform masculinities themselves. Including women will certainly further deepen the understanding of some of the constitutive elements of masculinity that men talked about in this study. These issues relate to being “good” provider, demonstrating sexual prowess and men’s claims about women’s pleasure in sexual relationships. As the interview settings were sites for the production of masculinity or gender performativity, men might have exaggerated their ability to enact certain forms of hegemonic masculinity (such as sexual prowess). Including men’s wives or girlfriends in a future sample could provide a deeper and perhaps a different understanding of men’s performative masculinity or sexual prowess. A more nuanced understanding of these issues may be developed by interviewing couples and then triangulating between the accounts that members provide.

22 According to Roy (2012), there are 59 adivasi or indigenous groups in Bangladesh. Some of the main ethnic groups living in Bangladesh are Chakma, Marma, Magh and Khasia.

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The intersections between socio-economic status and social generation in producing similarities or differences in masculinities have not been fully explored in this thesis. Since social generation was one of the key explanatory concepts, I attempted to analyse possible links between social generation and aspects of masculinity. It may however be the case that some of the differences and similarities in masculinities were co-produced by the intersections between social generation and socio-economic status such as class and occupation. Further research is therefore needed to explore the intersections between socio-economic status and social generations in relation to masculinities.

Some methodological reflections

Although the semi-structured interview method used in this study was well suited to the study of social generational masculinities and sexualities, it must be recognised that no method of enquiry is fully perfect for grasping the densely complex worlds where gender and sexuality collide (Plummer, 2010). While semi-structured interviews helped provide rich accounts, given the sensitivity of the research topic, perhaps many aspects of men’s sexual practices could not be known about through this study. A small number of potential participants refused to participate in this study because, perhaps, they did not want to discuss sexual health issues, while some who had had pre-marital sex were afraid of the disclosure of such information. In addition, non-participation by middle and younger social generation men who had initially expressed an interest may also have influenced the findings presented. During interviews with men of all social generations, there were occasions when participants avoided answering questions relating to sexual practices. Similarly, some of the questions asked about same-sex sexual relations appeared to produce discomfort for some research participants.

In a predominantly Muslim and conservative social setting such as that where this research was undertaken, both questions and responses, as well as research conversations, were underpinned by dominant cultural discourses of sexuality, gender and religion. Because of this, informants may have censored themselves while answering or discussing aspects of their selves as men and especially their sexual practices. Older social generation men, for example, did not talk much about same-sex behaviours and relationships, neither did they display much awareness of such practices. Men of all three social generations talked very little about non-partnered sexual

161 practices such as masturbation, which are viewed as embarrassing to discuss in countries such as Bangladesh. As I shared some of the same cultural sensibilities as the participants in this study, there were occasions where I too censored myself by not asking “too sensitive” questions about these and related matters.

It is important to note that research interviews are a site for social interaction in which people use symbols to communicate meanings. As interactionist sociologists have long argued, actors engage in meaning making, meaning giving, and impression management across a multiplicity of social settings (Goffman, 1956). In this respect, the interview context is no different. Some of the participants in this study may have engaged in impression management and by attempting to valorise the more performative aspects of masculinity (e.g., marital sexual prowess), while sometimes avoiding certain topics (same-sex sexual encounters).

Effective qualitative interviewing is underpinned by the relationship between the researcher and research participants and the nature of this relationship may influence the data that are co-produced in the interview (Connolly & Reilly, 2007, as cited in Cowburn, 2013, p. 186). For example, the gender of the researcher can influence the direction, tone and content of the research conversation (Cowburn, 2013, p.187), with male participants being more likely than women to express more misogynistic, sexist and homophobic attitudes to a male researcher than to a female researcher (Coates, 2003, p. 197, as cited in Cowburn, 2013, p. 187). Men’s engagement in particular forms of talk during an interview may be thought of as a language game, which reflects a “form of life” (Cowburn, 2013, 186-187). Forms of life imply different ways of being within particular cultural contexts (Cowburn, 2013, p. 185). As South Asian culture is largely heteronormative with strong homosocial bonds between men, study participants sometimes expressed sexist and homophobic views. At the same time, and paradoxically, the same homosocial bond helped build stronger rapport between some participants and myself.

Existing social hierarchies were also reproduced during the interviews. These hierarchies link closely to differences in age, education, prior knowledge about the study topic, power and so forth. Their presence can give rise to somewhat incompatible understandings of the topics discussed. Sometimes participants and I understood

162 different things in terms of notions of masculinity, sexual practices and sexual health. Some participants tended to consider masculinity and men as the same concepts, while I brought with me a different view. Many older and middle social generation men seemed to understand sexual health narrowly as sexual success through penetration or as not having worries about semen-loss, while my view of sexual health was much broader. The theoretical framework that I employed throughout the study enabled me to develop a progressively more nuanced understanding of the topics discussed during the interviews. Possible differences in the understanding of key terms between participants and myself need to be taken into consideration while interpreting the findings and conclusions in this thesis.

Finally, in the course of conducting this study and writing this thesis, my understanding of masculinity, gender and sexuality has deepened considerably. I have gained some useful insights into social generational masculinities, social generational sexual practices and health and help-seeking practices. I have moved from the somewhat essentialist understanding of gender I brought to the study at its initiation to an awareness of gender as performative, as plural and as provisional. My appreciation of men as gendered subjects has also deepened. I now realise how important it is to continue efforts to reconfigure, contest and resist the hegemonic masculinities that have such harmful effects on men, women and others. I have come to the insight that while constrained, masculinity is far from monolithic or fixed and that men therefore have a pivotal role to play in these efforts. Having completed this study, I now feel the urge to contribute more fully to gender transformative work in order to achieve greater gender justice, and hope to pursue such a goal through research, writing and activism.

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Appendices

Appendix A: Interview Guide

Masculinities, generations and health: Men’s sexual health in Bangladesh

Topic area 1: Background information

• Please tell me about yourself. It can include your education, work, and family.

• Probing questions relating to work, family, education, and intimate relationships to follow.

Topic area 2: Men and the social construction of masculinities

• What does it mean to be a man to you? What do you think real men should/ should not do? (Probing questions to follow).

• Has your notion of being a man changed over time? If so, why?

• How would you describe yourself as a man?

• Please tell me about the time when you felt you were making a transition from boyhood to manhood?

• During this transition, have you encountered any issues – body-related, and mental or physical health–related? (Probing questions to follow).

• What do you think about the body in terms of its strength and its susceptibility to diseases?

• How important do you think work is to men’s lives? How do you think work has impacted on your life?

• How would you describe your typical daily activities as a man? (Probing questions to follow).

- When do you feel most like a real man? In what situations?

- What do you think of younger or older man?

• Have you experienced any sexual health diseases such as STIs and/or HIV?

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Topic area 3: Sexuality and sexual health

• What comes to mind when I say sexual health? (Probing questions to follow).

– What does it mean to be sexually healthy?

– What does it mean to be sexually unhealthy?

• How important is it for men to enter into sexual relations? Do you try to satisfy yourself or partner? Who generally initiates sexual activity?

• Are you in a relationship? Is this relationship sexually active? Satisfactory?

• How does your sex life compare with that of other men’s in your opinion?

• Any sex outside marriage?

• Do you think you engage in any activities that you think could pose sexual health risk?

• Do you remember any situation where you thought you had a sexual health issue, but did not see or consult a doctor or a therapist?

• Did you seek health service for any sexual health issues? Why or why not? (Probing questions to follow).

- What do you think of available sexual health services?

• What do you think about men’s use of condom? Should they use? Why or why not? (Probing questions to follow).

• Do you use sexual health information? What are the sources?

• What do you think of the information received? Useful? Relevant?

• Do you discuss sexual health issues with your partners/friends or families?

• Who do you confide in? Who do you get support from?

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Appendix B: Participants’ socio-demographic profile

Older social generation men

Name23 Age24 Occupation Marital/relation- Religion Location ship status

Akkas 70 Cook Married Islam Gazipur

Mobin 62 Rickshaw puller Married Islam Gazipur

Mozammel 72 Retired Widowed Islam Gazipur

Bazlul 73 Retired Married Islam Gazipur

Adil 75 Retired Widowed Islam Gazipur

Mohaddes 53 Rickshaw puller Married Islam Gazipur

Kashem 75 Retired Widowed Islam Gazipur

Amir 55/56 Security staff Married Islam Gazipur

Forkan 55 Rickshaw puller Married Islam Gazipur

Halim 70 Caretaker-cum- Married Islam Chittagong security guard

23 All are pseudonyms. 24 Some older men did not know how old they were. For them age mentioned is approximate.

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Middle social generation men

Name Age Occupation Marital/ Religion Location

(Years) relationship status

Islam 35 Office assistant Married Islam Chittagong

Dulal 46 Office assistant Married Hinduism Chittagong

Zeshan 51 College teacher Married Islam Chittagong

Nazrul 40 College teacher Married Islam Chittagong

Alim 30 Driver Married Islam Gazipur

Shahit 34/35 Factory worker Married Islam Gazipur

Salam 35 Van driver Married Islam Gazipur

Masud 37 Van driver Married Islam Gazipur

Khairul 34 Street vendor Married Islam Gazipur (sells tea, biscuits etc.)

Majid 35 Factory worker Married Islam Gazipur

Salim 40 Factory worker Married Islam Gazipur

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Younger social generation men

Name Age Occupation Marital/relationship Religion Location status

Pial 22 University student In a romantic- Islam Gazipur heterosexual relationship

Nahian 27 Independent Currently single, Does not Dhaka researcher numerous hetero- believe homosexual relations and in any encounters religion

Foysal 25 University student Single, has had a long- Islam Dhaka distance romantic relationship

Rahul 22 University student In a romantic- Hindu- Dhaka heterosexual relationship ism

Ali 21 College student In a romantic relationship Islam Gazipur and sales reprehensive

Russell 27 Systems engineer In a romantic- Islam Dhaka heterosexual relationship

Karim 21 University student In a romantic- Islam Chittagong heterosexual relationship

Imran 20 University student Single Islam Chittagong

Nurul 19 Security guard Single (no sexual Islam Chittagong contact)

Helal 24 University student Single (has multiple Islam Dhaka casual male partners)

Fahim 22 College student In romantic relationship Islam Dhaka (has multiple casual male partners)

Roshid 27 Electrician Married Islam Gazipur

Babor 22 Van driver and Married Islam Gazipur day labourer

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Appendix C: Research ethics approval letter

HUMAN RESEARCH ETHICS COMMITTEE (HREC)

29-Nov-2013

Professor Peter Aggleton Sydney NSW 2052

Dear Professor Aggleton,

HREC Ref: # HC13307

Masculinities, generations and health; Men's sexual health in Bangladesh

The Human Research Ethics Committee considered the above protocol at its meeting held on 26-Nov-2013 and is pleased to advise it is satisfied that this protocol meets the requirements as set out in the National Statement on Ethical Conduct in Human Research*. Having taken into account the advice of the Committee, the Deputy Vice- Chancellor (Research) has approved the project to proceed.

Would you please note:-

approval is valid from 26-Nov-2013 to 25-Nov-2018;

you will be required to provide annual reports on the study’s progress to the HREC, as recommended by the National Statement;

you are required to immediately report to the Ethics Secretariat anything which might warrant review of ethical approval of the protocol (National Statement 3.3.22, 5.5.7: http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/e72.pdf) including:

serious or unexpected outcomes experienced by research participants (using the Serious Adverse Event proforma on the University website at http://research.unsw.edu.au/human-ethics-forms- and-proformas ;

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proposed changes in the protocol; andunforeseen events or new information (eg. from other studies) that might affect continued ethical acceptability of the project or may indicate the need for amendments to the protocol; any modifications to the project must have prior written approval and be ratified by any other relevant Human Research Ethics Committee, as appropriate; if there are implantable devices, the researcher must establish a system for tracking the participants with implantable devices for the lifetime of the device (with consent) and report any device incidents to the TGA; if the research project is discontinued before the expected date of completion, the researcher is required to inform the HREC and other relevant institutions (and where possible, research participants), giving reasons. For multi-site research, or where there has been multiple ethical review, the researcher must advise how this will be communicated before the research begins (National Statement 3.3.22, 5.5.7: http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/e72.pdf); consent forms are to be retained within the archives of the HIVSRC - National Centre in HIV Social Research and made available to the Committee upon request.

Sincerely,

Associate Professor Heather Worth Presiding Member

Human Research Ethics Committee

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Appendix D: Participant Information Statement and Consent Form

Approval no. HC13307

THE UNIVERSITY OF NEW SOUTH WALES

Masculinities, generations and health: Men’s sexual health in Bangladesh

Your participation You are eligible as a possible participant to take part in my doctoral project entitled ‘Masculinities, generations and health: Men’s sexual health in Bangladesh’. You were selected as a possible participant in this study because you are a man and belong to one of the three generations from whom data will be collected. I provide some information below for you to read through and decide whether you would like to participate in this study.

About the study The aim of this study is to find out more about the implications of masculinities for men’s sexual health in Bangladesh. Masculinity means different ways of being a man. The information that you provide will help us better understand men’s sexual health concerns, health seeking behaviour, sexual health risk and management in relation to masculinities. Any Bangladeshi man aged 18 years old and/or above can participate in this study. The study is being carried out at the Centre for Social Research in Health (CSRH) at the University of New South Wales (UNSW). The research is supervised by Professor Peter Aggleton and Dr. Asha Persson at CSRH.

What Does It Involve? If you decide to participate, I will talk to you about a range of issues related to your background, including age, work, cultural and religious beliefs and practices, and important events in your life, Moreover, I will ask you about your ideas of being a man, and how being a man has influenced your work, thoughts and behaviours, including sexual practice; perceptions around sexual risk and safety; the use of sexual health services and other social, emotional and everyday impacts of being a man. The semi-structured, in-depth interview format allows you to thoroughly explore these issues and tell your story in your own way. The interview will take about 1-2 hours to complete and will be recorded with a digital voice recorder.

Confidentiality and Disclosure of Information Your personal information will be kept anonymous and confidential. Any information obtained in connection with this study that can be identified with you will remain confidential and will be disclosed only with your permission, except as required by law. Original digital recordings will be destroyed as soon as they have been transcribed. Any information that can identify you will be changed or deleted from the transcribed interview. The information that you provide will be de-identified, password protected and safely stored at CSRH at UNSW. Only the research team will have access to the de-identified interview transcripts. No third party will have access to your personal information and data. All electronic and hard copies of transcribed interviews will be kept for a required seven years after the study has ended and will then be deleted and/or shredded, or archived in a de-identified form. If you give us your permission by signing this document, the information collected for this study will be used in a PhD thesis and in subsequent publications such as journal articles and conference papers. However, your identity will not be revealed in any publications based on the information that you provide.

Recompense Reimbursement for any out-of-pocket expenses incurred in relation to participating in an interview, such as travel costs, and time spent will be made available to all participants (Taka 500). Participants who do not wish to receive any reimbursement can elect to donate it to the Centre for Rehabilitation of the Paralaysed (CRP), Savar, Dhaka.

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Feedback Non-copyright publications can be sent to you electronically via email or through the post. If you would like to receive these publications as they become available, please provide me with an email or postal address. These contact details will not be linked to your interview data and will be destroyed once all study publications have been circulated.

Your Consent Participation in the project is entirely voluntary. You have the right to withdraw from participation at any stage of the interview process or may request to turn off the voice recorder. Even if you agree to be recorded, you may choose to have the recorder turned off at any time. You have the right to decline to answer a particular question or discontinue the interview at any time without prejudice. If you decide not to participate in this project it will not affect your future relations with The University of New South Wales, with CSRH, with any of the collaborating organisations, or the services provided to you by any health service. Complaints may be directed to the Ethics Secretariat, UNSW Grants Management Office, Level 3, Rupert Myers Building (South), The University of New South Wales, SYDNEY 2052 AUSTRALIA (phone 61 2 9385 4234 (ext. 54234) / 9385 5170 (ext. 55170) or e-mail: [email protected]. Alternatively, you may contact the Department of Economics and Social Sciences, BRAC University, 66 Mohakhali, Dhaka, Phone: 02-8815 520 (email:[email protected]) to register any complaint. Any complaint you make will be treated in confidence and investigated, and you will be informed of the outcome.

Support Services

In case your feel distressed for taking part in this interview and need assistance, please call the helpline of Bandhu Social Welfare Society on 0171- 4048418. You may also contact Kamrul Hasan on 0181-1146574 for advice regarding where to seek assistance in the unlikely event of distress.

How to get in touch with us? If you have any questions now, please feel free to ask the researcher. If you have any additional questions later, please contact Md Kamrul Hasan on 880-1811146574 or + 61 410 506 574, or email: [email protected]. You will be given a copy of this form to keep.

This study has been approved by the Human Research Ethics Committees of the University of New South Wales (approval no: ...). If you have any worries or concerns about the study, please contact the Department of Economics and Social Sciences, BRAC University, 66 Mohakhali, Dhaka, Phone: 02-8815 520 (email:[email protected]) or the UNSW Ethics Secretariat, phone: + 61 2 9385 4234 or email: [email protected]. Any complaint you make will be investigated promptly and you will be informed about the outcome.

You will be given a copy of this form to keep.

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Lead Investigator: Professor Peter Aggleton, Centre for Social Research in Health, UNSW, Phone: 61 2 9385 6669, Email: [email protected]

You are making a decision whether or not to participate. Your signature indicates that, having read the information provided above, you have decided to participate.

I have read and understood the information for participants provided about this study. I have been informed about what is involved in the study, including any known or possible inconveniences or risks. I also understand that my participation in this study is strictly confidential. I also understand that participation in this study is completely voluntary and that I can withdraw my consent or decline to answer a question without prejudice.

…………………………………………………… .……………………………………………………. Signature of Research Participant Signature of Witness

…………………………………………………… .……………………………………………………. Please PRINT name Please PRINT name

…………………………………………………… .……………………………………………………. Date Nature of Witness

Additional consent (optional, not required for participation in this study) Please tick box and initial to show that you are consenting to:

Please send me a brief summary of the research findings and other publications as they become available.

Email/Postal address: ______

______

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Approval No. HC13307

REVOCATION OF CONSENT

Masculinities, generations and health: Men’s sexual health in Bangladesh

I hereby wish to WITHDRAW my consent to participate in the research proposal described above and understand that such withdrawal WILL NOT jeopardise my relationship with The University of New South Wales or any services provided to me by any of the collaborating organisations.

I understand that I have the right to decline to answer any question or discontinue the interview without prejudice.

…………………………………………………… .……………………………………………………. Signature Date

…………………………………………………… Please PRINT Name

The section for Revocation of Consent should be sent to Md Kamrul Hasan, Centre for Social Research in Health, Goodsell Building, Level 2, University of New South Wales, Sydney, 2052.Australia.

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