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 r .. s ( . ' :~ - ,\ l ! S I R 1\ l I ,,\ 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. Declaration relating to disposition of project thesis/dissertation I hereby grant to the University of New South Wales or its agents the right to archive and to make available my thesis or dissertation in whole or in 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 property 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 Abstracts International (this is applicable to doctoral theses only) . /M· kCi,¥,tW. -1/a.Jo.frl lb �f-kYhb-h '261, ··· ··· · · · ·· · · ·· · ··· · ···· ··· · ······-·· · · · ······ ···· · ··· · ·· · ............................� , ....... ,....... ................... ............ , . ... ...... , ...... Signature Witness Signature Date The University recognises that there may be exceptional circumstances requiring restrictions on copying or conditions on use. Requests for restriction for a period of up to 2 years must be made in writing. Requests for a longer period of restriction may be considered in exceptional circumstances and reauire the approval of the Dean of Graduate Research. FOR OFFICE USE ONLY Date of completion of requirements for Award: THIS SHEET IS TO BE GLUED TO THE INSIDE FRONT COVER OF THE THESIS Originality and copyright statement 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. 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, 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