The strengths and weaknesss of a men’s health approach to domestic and sexual violence

In the last two years, men’s health approaches have had growing visibility in the violence prevention field. Some men’s health advocates have argued for the value of a “men’s health lens” on domestic violence.

Men’s health approaches have both strengths and weaknesses in engaging men and boys in the prevention of domestic and sexual violence.

Strengths: 

  • Attention to male needs: Men’s health approaches bring a welcome attention to men’s and boys’ own situations and needs. They fit well with the violence prevention field’s established emphasis on engaging men and boys as stakeholders and beneficiaries in change.
  • Appeals to benefit: If men’s health approaches can frame violence prevention as a matter of improving men’s own wellbeing, this could motivate participation in programs and behaviour change. Violence prevention work with men and boys already routinely embodies an emphasis on how men and boys will benefit from progress towards non-violence and gender equity (Flood, 2015; 2019, pp. 88-89, 105-108), and men’s health approaches could extend this.
  • Reducing backlash: Positioning violence as a health issue may reduce men’s defensive or hostile responses to violence prevention efforts, and may encourage men to seek support or help, whether for perpetration, victimisation or related challenges.
  • Attention to masculine norms: Men’s health approaches often emphasise the masculine social norms that influence men’s health and wellbeing, and a similar emphasis is visible in the prevention field’s emphasis on the masculine and gender norms implicated in violence perpetration.
  • Addressing risk factors: A men’s health approach may emphasise risk factors for the perpetration of domestic or sexual violence that are worthy of attention, such as trauma, mental ill-health, and violence victimisation. It may connect violence to other men’s health issues, such as substance abuse, depression and suicide, highlighting shared determinants and allowing integrated prevention and intervention strategies.
  • Addressing male victimisation: A men’s health approach will highlight the fact that many victims of interpersonal violence in general, and domestic and sexual violence in particular, are men and boys, and may lead to greater services and support for male victims.
  • Reaching men: Health services and systems are a potential vehicle for reaching men (as are other settings and services, including education, fathering, sport, work, faith, and so on). For instance, workplace mental health initiatives could incorporate discussions about healthy relationships and gender norms. In this way, a men’s health approach could expand the entry points for intervention.

Weaknesses:

  • Ignorance of and inexperience in domestic and sexual violence: Men’s health approaches have shown little attention to domestic or sexual violence or other forms of violence. Men’s health practitioners and advocates typically lack subject matter expertise regarding domestic violence and sexual violence
  • Neglect of gender, power and harm: Men’s health approaches may not involve the understandings of gender and power that are relevant in addressing domestic, family and sexual violence. Men’s health approaches may see men and boys only as victims and focus only on their needs and wellbeing, and not also on the harms that some men and boys cause to others.
  • Neglect of power and entitlement: Framing violence prevention only as a matter of improving men’s own wellbeing will push aside questions of patriarchal power, what the men who use violence gain from this violence and what they will have to give up. That is, it would miss important dimensions of domestic and sexual violence, rather than addressing them as a key element in change.
  • Depoliticising and individualising violence: A men’s health approach may depoliticise violence, individualising the issue and  diverting attention from systemic gender inequality as a key driver of violence. Health-oriented framings of perpetrators and perpetration may focus only on psychological or medical factors rather than recognising the structural, cultural, and gendered roots of violence.
  • Focus on individual and psychological factors: Men’s health approaches may focus on individual and psychological factors, neglecting social and structural ones. In turn, men’s health strategies may focus on individual change and health system responses, rather than other means of social change.
  • Sticking with what’s comfortable: Men’s health approaches may assume that any approach that causes men and boys discomfort or resentment necessarily is an ineffective approach and should be abandoned, but some such approaches are necessary in challenging patriarchal attitudes and behaviours (although approaches that cause only strong resistance are unlikely to make positive change). Our overriding criteria for what language, messages and so on to use in engaging men and boys should not be what makes men and boys feel comfortable or good, but what makes positive personal and collective change.
  • Neglect of safety and accountability: Men’s health approaches are not necessarily informed by the principles of safety and accountability that characterise the violence prevention field, nor by a spirit of partnership with women and women’s services and organisations.
  • Reinforcing a focus on men: A men’s health lens might shift attention away from women and children, who make up the vast majority of victims of domestic and sexual violence, and downplay the urgent need for survivor-centred responses.
  • Promoting myths of gender symmetry: Attention and responses to male victims, done badly, may reinforce the myths that domestic violence is gender-equal and that women’s violence against male intimate partners is as common or as serious as men’s violence against female intimate partners.
  • Marginalising women’s voices: Prioritising men’s health could inadvertently recenter men’s experiences and marginalise women’s and victim-survivors’ voices in a movement historically led by women’s advocacy.
  • Limited evidence of effectiveness: Few rigorously evaluated programs among men and boys exist to confirm that health-focused strategies reduce violence.
  • Enabling anti-feminist advocacy: The men’s health field includes some anti-feminist groups and agendas. This is one area where ‘men’s rights’ ideologies have established some seeming legitimacy (Salter, 2016), and they are antithetical to informed, safe, and effective prevention work.

Some of these limitations have been visible in some recent commentary on the violence prevention field, including:

  • Misrepresentations of work with men and boys as characterised in general by blaming and shaming approaches;
  • Divisive and inaccurate accounts of the violence prevention field e.g. as focused only on gender-related drivers of domestic and sexual violence or as focused only on attitudes;
  • Accounts of men and boys only as victims.

An issue that has been a focus of men’s health advocates’ recent commentary on engaging men and boys is trauma. Yes, it is vital that we address trauma in men’s and boys’ lives. This is recognised in the ‘engaging men’ field, including by key international organisations focused on engaging men such as Promundo (Slegh et al., 2021). However, there are simplistic assumptions that we should avoid.

  • Trauma (such as childhood exposure to violence) is an important risk factor for men’s perpetration of DV, but it is certainly not the only risk factor nor the primary one (Flood et al., 2023, pp. 30-42). Nor is violence perpetration always the result of trauma.
  • Misogyny (anti-women hostility) has a range of drivers and supports, including widespread cultural norms of sexism. Yes, it is shaped by childhood trauma, but it would be mistaken to assume that trauma is the only or primary driver of misogynist attitudes among boys and men.

Ways forward

Work with men and boys for violence prevention:

  • Must be based on sound, evidence-based understandings of violence, gender, power, and masculinity
  • Must be guided by the evidence on what works and on emerging standards for effective practice.

Although men’s health approaches have potential weaknesses in addressing violence against women, critical health approaches or ‘health equity’ approaches are stronger. They show greater emphasis on social and structural determinants of health and greater attention to addressing social injustice. (See, for example, the report by the Prevention Institute & National Sexual Violence Resource Center (2021).) A critical and intersectional men’s health approach can highlight how overlapping systems of oppression harm both men’s health and women’s safety. It could provide purchase in addressing structural inequalities, including their interrelationships with dominant constructions of masculinity. Men’s health approaches that are gender-transformative and intersectional are more likely to contribute to significant positive change.

While a men’s health lens offers pragmatic entry points for engagement, it must be embedded within broader efforts to transform gendered power structures. Failure to do so risks superficial solutions that leave the drivers of violence intact.

 

Further resources and readings

References

Flood, M. (2015). Work with men to end violence against women: a critical stocktake. Culture, Health and Sexuality, 17(Supp2), 159-176. 

Flood, M. (2019). Engaging Men and Boys in Violence Prevention. Palgrave Macmillan. 

Flood, M., Brown, C., Dembele, L., and Mills, K. (2022). Who uses domestic, family, and sexual violence, how, and why? The State of Knowledge Report on Violence Perpetration. Brisbane: Queensland University of Technology.

Prevention Institute & National Sexual Violence Resource Center. (2021). A Health Equity Approach to Preventing Sexual Violence. 

Salter, M. (2016). Men’s Rights or Men’s Needs? Anti-Feminism in Australian Men’s Health Promotion. Canadian Journal of Women and the Law, 28(1), 69-90. 

Slegh, H., Spielberg, W., & Ragonese, C. (2021). Making the Connections: Masculinities and Male Trauma. Promundo-US.