Operationalising masculinities in theories and practices of gender-transformative health interventions: a scoping review

Abstract

Gender-transformative health interventions that involve men and boys are gaining global reach, adaptability to specific geographical, population and epidemiological contexts, public endorsement, and conceptual sophistication. However, the ways in which masculinities are conceptualised and operationalised in theory and practice across these interventions remains unclear. The purpose of this scoping review is to map intervention studies that conceptually grapple with masculinities and analyse: a) how the concept of masculinities is adapted and operationalised in gender-transformative interventions, with respect to intervention population and context, b) what the relationship between the concept of masculinities and its wider theoretical embedding is, and c) on which levels transformation can be observed when working with ‘masculinities’.We conducted a search in APA Psych Articles, APA PsycINFO, and CINAHL via EBSCO, MedLine, PubMed, and Web of Sciences (December 2021) looking for peer-reviewed studies on gender-transformative health interventions which engaged with masculinities conceptually. There were no restrictions regarding language, publication date, or geography. Forty-two articles were included in this review. Our abductive analysis finds that ‘hegemonic masculinities’ is a central concept in almost all included studies. This shows how the concept is adaptable to a range of different intervention contexts. The review further identifies five theoretical approaches, that help operationalise masculinities on an analytical level: feminist framework, affect theory, critical pedagogy, theories of social change, and ecological approaches. Lastly, this review draws out six levels on which transformation can be observed in the intervention outcomes: relational level, symbolic level, material level, affective level, cognitive-behavioural level, and community-structural level. The discussion underlines that processes and practices of (gender) transformation also require engagement with theories of transformation more widely and advocates for theoretical pluralism. Lastly, implications for practice, including preventative, ecological and community-based care models, are drawn out.

Approaches to Engaging Men During Primary Healthcare Encounters: A scoping review

“…Many of the gender-responsive engagement approaches and ''male-friendly'' examples offered in the articles extracted within this review were typically emblematic of traditional masculinity as the singular lens to view and respond to men during their engagement with healthcare rather than it being a consideration. This was also identified by Zielke et al (2023) in their review of the operationalisation of ''masculinity'' across gender-transformative health interventions. Gender is dynamic and modifiable, and this includes men's masculine identities which will adapt to the different social environments including healthcare settings.…”

“…Resulting insights into the specificities for what works may offer some potential for transferability and translation to other local settings where primary healthcare systems have struggled to engage men. The sensitivities and nuances in approaches to engagement then need translation into HCP education, if we are to reduce health inequities (Baker & Shand, 2017;Zielke et al, 2023) experienced by the most marginalized and vulnerable groups of men globally.…”

“Hey Amir, How Are You REALLY Doing?”: Participant Perspectives of a Peer-Based Suicide Prevention Campaign for Men

“…Many participants in the present study demonstrated a profound awareness and understanding of these complexities by actively working with and around masculine norms to promote men’s mental health. Particularly following the COVID-19 pandemic, the diversity and prevalence of mental health challenges among men suggests the need to carefully consider strategies for addressing gender norms, roles, and relations ( Zielke et al, 2023 ). Findings demonstrated how men’s suicide prevention is inescapably linked to masculinities.…”

Masculinity and addiction: a narrative review of therapeutic interventions for men with substance-use disorders

“…Alcoholism & Drug Addiction / Alkoholizm i narkomania 2023; 36,3 what extent, they engage in SUD treatment. Recognising the limitations of male gender roles by both patients and therapists is therefore an important part of the therapeutic process.…”

“…The development of the New Masculinity Inventory, with its 17 items covering the domains of 'holistic attentiveness' , 'challenging male norms' , 'authenticity' , 'domesticity & nurturing' and 'sensitivity to male privilege' [5: 421], addresses this gap and paves the way for future comprehensive, more valid, study outcomes. At the same time, this broader perspective also informs practice; a review of how masculinity is operationalised in the context of gender-transformative health interventions still shows the dominance of the limited concept of hegemonic masculinities [36].…”