Improving global women’s health is both a noble and necessary endeavor, as well as a daunting task. There is no cookie-cutter solution to the myriad of issues women face. While there may not be a simple answer, there is a challenge to be offered; one that calls for the engagement of boys as integral to the next generation of leaders in women’s health. Inherent in that challenge also lies a solution; a way of overcoming social, economic, cultural, and gender barriers to build a bridge between today’s public health issues and tomorrow’s public health victories. Today’s boys are set to inherit a world in which they, simply by virtue of being men, will hold a great deal of power. If that power can be leveraged for positive change through open communication, gender sensitive education, and men’s ownership of the women’s health agenda, great progress can be achieved.
Research by the World Health Organization (WHO) has shown that inequities in gender norms influence the ways in which men interact with their partners, including in prevention behaviors related to sexual and reproductive health.
In fact, social expectations of male behavior directly reflect attitudes and behaviors related to HIV prevention, among other relevant sexual health issues. Sexual identity development and sexual behavior adoption does not occur in isolation from one’s social environmental context. The perceived expectations of a society will drive the norms, and as a result the actions, of its members–youth in particular. Men and boys at an individual level learn and come to internalize cultural gender norms and prevailing patterns of hegemony and patriarchy. They can, and do, however, also react to and question these norms. The social meanings of ‘manhood’ and the social expectations that come with them are in large part constructed in relation to prevailing social norms of woman or girlhood. They are also built against the backdrop of other power structures and dynamics borne from any number of other differentiating factors, such as income. Gender norms and social definitions of manhood, therefore, exist within the context of other power dimensions and social realities, and are particularly powerful among youth who are still forming their identities and adopting related behaviors.
Traditional expectations about what it means to be a man or a woman, integral to the adolescent socialization process, are potentially detrimental for adolescents dealing with their sexuality and trying to protect their health. The common stereotypes of powerful males and submissive females exacerbate existing barriers to quality sexual and reproductive health services. These stereotypes of misogyny and subservience, perpetuated in many of today’s societies, serve to restrict access to health information, limit communication between young couples, and encourage risky behavior. young adults who use condoms during their first sexual encounter are more likely to sustain condom use later in life; however power imbalances, for example, can increase the difficulty of refusing sex or negotiating safer sex, for adolescent girls. Together, these normative gender roles increase adolescent vulnerability to threats to their sexual health, including violence, unplanned pregnancies, unsafe abortion, STIs and HIV/ AIDS. Beyond adolescence, these retrogressive socio-cultural norms, along with (the perhaps related) comparatively low educational attainment of women compared to men, have resulted in low participation and representation of women in positions of decision-making and restricted their access to opportunities for advancement.
Women’s health is not just about adult women. Addressing one single age group, one gender in isolation, or even a single community without addressing the many global forces infiltrating it, is not sufficient to achieve true “transformative” change. Gender identities and related sexual norms and sexual behaviors are so deeply engrained in, and intricately intertwined with, family, community, and society-level contexts that true transformation will only occur when programs and policies are able to adequately address these higher level influences. We cannot expect to realize sustainable improvements in women’s health if we do not do justice to the roles that men play in the dynamics that perpetuate and exacerbate many of the problems women face, and in their capacity to change those dynamics to improve outcomes for themselves and women alike. Engaging boys is a positive step forward. Through encouraging collective action and support, informing youth of their rights, promoting a sense of community, and establishing associations through which they can share their common experiences and concerns, education can serve to break through the cycle of ignorance, violence, and risky behavior by altering, among other things, the expectations around sexual behavior and gender roles and relationships. The authority and responsibility to ensure the provision of these things and make gender-equitable youth leadership possible requires bringing together multiple stakeholders from governments to NGOs, to the private sector and families and communities alike.
Recognizing, as we all move determinedly towards the goal of gender equality worldwide, the importance of ensuring that men and boys are engaged in the same education, advocacy, and programs as women and girls is critical to achieving the full health and well-being to which they are entitled. Efforts to improve outcomes in sexual and reproductive health must be gender-inclusive. One of the keys to improving global women’s health, and in particular sexual and reproductive health, is engaging youth and providing mechanisms through which they can make sustainable change. After all, it is they, as the next generation of leaders, upon whom making a real difference is dependent. The role that young men in particular play in the landscape of global women’s health is critical, albeit often overlooked. Their place in creating change for their own generation, as well as in supporting the change that is being implemented by, and on behalf of, women, is essential to ensuring the sustainability of progress.