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Governing Masculinity: How Structures Shape the Lives and Health of Dislocated Men in Post-Doi Moi Vietnam Le Minh Giang Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy under the Executive Committee of the Graduate School of Arts and Sciences COLUMBIA UNIVERSITY 2012 @2012 Le Minh Giang All Rights Reserved ABSTRACT Governing Masculinity: How Structures Shape the Lives and Health of Dislocated Men in Post-Doi Moi Vietnam Le Minh Giang Since the start of Doi Moi (Renovation) over twenty years ago, Vietnam has increasingly opened its society and economy to the global capitalist economy and culture. The country has witnessed numerous changes in all aspect of everyday life, affecting individual men and women, their relationships with each other, and their relationships with other social and political institutions. My dissertation explores the challenges that three groups of dislocated men – men who were migrant laborers from a rural setting; men who were among the first methadone patients in the country; and men who sold sex to other men in Hanoi – were facing as they were struggling to build their manhood and to establish (or reject) aspects of culturally prescribed masculinities in post-Doi Moi Vietnam. I focus on their experiences with three structures, namely the market- bound socialist state, the fledgling capitalist market, and the patriarchal family, that together shape these men’s everyday life struggles, their ethics of the self (especially their imagining of themselves as trụ cột gia đình, the pillar of the family), and ultimately their lives and health. I argue that in the context of post-Doi Moi Vietnam, these three powerful structures constitute, and are constituted by, the political economy of the male body, and that this relationship between structure and the body are best represented in the experiences of the men in this study. The male bodies examined here include: the exploitable body of migrant labors whose paths to manhood are limited by their lack of resources and capital other than their own sweat, tears, and flesh; the deviant body of men whose adherence to the regime of state-sponsored methadone is their only hope to recover from social death caused by their past heroin use; and the rejected body of men selling sex to other men who face the “problem of recognition.” My analysis shows that their embodied forms of labor, whether on a highway, in a drug treatment center, or in a sexual marketplace, play a critical role in the making of their manhood. Their bodies are at the same time useful and disposable under the logics of power operated by the three powerful structures that offer possibilities, limitations, and various forms of desire (economic, erotic and ethical). While the male body of dislocated men bears great potential for man-making, they are also highly vulnerable to the exploitative practices of the state, to the vagaries of the market, and to disappointment of their own families. My dissertation shows various strategies, however seemingly premature, fragile and sometimes detrimental to their health, which these men deployed to overcome barriers and to make the best use of their limited resources in order to make their road to become trụ cột gia đình. These strategies, I will show, are forms of “strategic” and yet structurally determined decisions and action of these men, and they reflect constrained agency in confrontation with the “structural violence” that shapes experiences of dislocation, marginalization and stigmatization, and aggravates their vulnerability to HIV/AIDS. My dissertation contributes to social science theory of men and masculinities by bringing to the center of analysis the lived experiences of men in post-socialist settings that are often at the margin in studies on men and masculinities. My dissertation also contributes to the burgeoning literature on men and HIV/AIDS, and men’s health in general, through deepened analysis of the political economy of the male body and the relationship of this political economy with vulnerabilities in relation to HIV/AIDS and other health issues. Table of Contents List of Figures and Photographs ii Acknowledgments iii Dedication vii Chapter 1 Introduction: Critical Studies of Men, Masculinities and Health in Post-Doi Moi Vietnam 1 Chapter 2 The Social and Cultural Construction of Vulnerable Bodies: Men Who Migrate in Rural Thanh Hoa 58 Chapter 3 The Management of Deviant Bodies: Men Who Are on Methadone in Urban Hai Phong 134 Chapter 4 The Production of Rejected Bodies: Men Who Sell Sex in Hanoi 199 Chapter 5 Doi Moi and the Male Body: Implications for Theory on Men’s Health 270 Bibliography 281 Appendix 1: Some Characteristics of the Interview 322 Participants Appendix 2: Interview Protocols 336 i List of Figures and Photographs Figure 1 Map of Northern Vietnam and Location of the Research Sites 54 Photograph 2.1 Socialist Image of Men and Women 76 Photograph 2.2 State-Sponsored Image of Gender in Post-Doi Moi 76 Photograph 2.3 Market Image of New Men on the Streets of Hanoi 77 Photograph 2.4 Power of Consumption – Wedding in Luu Khue 77 Photograph 2.5 A Happy Man 78 Photograph 2.6 Killing Time While Waiting for Work in Hanoi 78 Photograph 2.7 Life on the Highway 79 Photograph 2.8 New House of a Man who was a Migrant Laborer 79 Photograph 3.1 Ministry of Health’s Poster Photos of Methadone Program 161 Photograph 3.2 A Happy and Healthy Couple: Poster Photo by FHI360 162 Photograph 3.3 Patients Taking Water from the White Tank to Swallow 163 Methadone Doses Photograph 3.4 Queuing for Daily Methadone Doses 163 Photograph 3.5 Hanging Out at a Tea Stall After Taking Their Doses 164 Photograph 3.6 Notice Board with Instructions on Prohibited Activities 164 Photograph 4.1 A Tẩm Quất Shop at Night 221 Photograph 4.2 Night Market by the Lake Site 222 Photograph 4.3 No Place Called Home: A Common Experience 222 Photograph 4.4 Home Away From Home: A Girl Friend and a Place To Stay 223 ii Acknowledgments I have accumulated many debts that a dissertation of this nature – which takes many years and multiple efforts to complete – has inevitably incurred. There are no words that could express my gratefulness to the unwavering support and unimaginable patience that have been given to me from my advisors, sponsors, mentors, colleagues, friends, and families in New York, Hanoi, Thanh Hoa, and Hai Phong. I hope that my dissertation convinces them that their love and care for me are justified. In New York, I have benefited greatly from the very supportive dissertation committee members whose knowledge, collegiality and exemplary work have been a constant source of inspiration for me over the many years. I have benefited immensely from working under the supervision of Professor Richard Parker, whose long-term research and advocacy engagement in Brazil have always inspired me since the day that I first took his class on ethnographic methods. His patience with my divergences from the tasks involved in completing the dissertation, which were frequent, is immeasurable and continues down to the wire, and for which I am most grateful. Over the past few years, I have also learned so much from working with Professor Parker on important international work on sexuality politics, which certainly brings new insights and inspirations for my own work. Professor Jennifer Hirsch is another source of constant intellectual support as she continues to ask practical and yet critical questions from the day when she read very early pieces of my dissertation. She is also excellent mentor and colleague on the NICHD-funded partnership of Department of Sociomedical Sciences and Hanoi Medical University (STAR Partnership), which has given me a strong foundation to do work that has contributed to my career development. I want to thank Professor Lesley Sharp for providing iii very insightful comments on the earlier draft of this dissertation which, as in the case of my dissertation research proposal, made me realize that how much I still have to learn. Professor Miguel Munoz-Laboy is a friend first and foremost, and I thank him especially for his warm hugs when we met every time I came for brief periods to New York, which always lifted my spirits. At Columbia University, I owe a huge debt to the late Dean Allan Rosenfield, M.D., who supported my application for graduate study and yet always reminded me of my duty first and foremost to Vietnam. He wanted me to finish my graduate study as soon as possible, and I will always owe him a nice photo of a graduation ceremony that should have taken place while he was still the Dean. I also want to thank a number of faculty and staff at the Department of Sociomedical Sciences – Professor Ronald Bayer, Professor Amy Fairchild, Professor Kim Hopper, Professor Carole Vance, Rosalie Acinapura, Andrea Constancio, and Toya Smith – who have given me encouragement, gentle nudges, and concrete support in every step of my graduate study as well as of finishing the dissertation. Also in New York, I have also benefited immensely from working with two other colleagues and friends, Professor Michael Clatts, now at University of Puerto Rico School of Public Health, and Dr. Lloyd Goldsamt at National Development and Research Institutes (NDRI), whose collaboration with me on the work in Vietnam over the years has undoubtedly contributed to this dissertation. In Hanoi, I owe my debt to the late Rector of Hanoi Medical University, Professor Ton That Bach M.D., who gave his blessing for my graduate study in America, which in late 1990s was still a rare phenomenon in Vietnam.

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