Competition and humiliation: how masculine norms shape men’s sexual and violent behaviors

Abstract

We use data collected from in-depth interviews with men (n=30) in the Dominican Republic to explore how men’s concern about being perceived as masculine influences their interactions with their social networks and how those interactions drive men’s sexual behaviors and use of violence. Men’s sexual and violent behaviors were shaped by the need to compete with other men for social status. This sense of competition also generated fear of humiliation for failing to provide for their families, satisfy sexual partners, or being openly disrespected. In an effort to avoid humiliation within a specific social group, men adapted their behaviors to emphasize their masculinity. Additionally, men who were humiliated recouped their masculinity by perpetrating physical or emotional violence or finding new sexual partners. These findings emphasize the need for understanding these social dynamics to better understand men’s violent and sexual behaviors.

Introduction

The social constructivist view of gender posits that gender is not an inherent trait of an individual, but rather is constructed through social interactions (West and Zimmerman 1987, Connell 1995). This distinction puts the focus on the actions of individuals, and importantly, the institutions and social network members that ascribe meaning to those actions. Additionally, this view sees power inequalities as central to understanding gender and associated dynamics (Connell 1987, Kimmel and Messner 2001). In the past two decades, masculinity theorists have focused on these power inequalities, including those between society’s constructed “hegemonic masculinity” (i.e. most dominant form of masculinity in a society’s pattern of gender relations) and the other types of masculinities (Connell 1995, Hyde et al. 2009, Lusher and Robins 2010). The influence this system of power has on almost all males in a society is extremely important to their behaviors (West and Zimmerman 1987, Courtenay 2000, Butler 1993). As men weigh how to act in a particular situation, their position in this power structure, and their desire to maintain position or advance, will typically play a role in how they behave. In this paper, we explore these theoretical concepts of gender and power within men’s social interactions using data collected from in-depth interviews with thirty men in the Dominican Republic (DR). Specifically, we aim to explore how masculine norms influence men’s social interactions and how those interactions drive men’s sexual behaviors and use of violence.

Previous Work on Caribbean and Dominican Masculinities

De Moya (2004), a prominent Dominican masculinities scholar, wrote about the socialization of Dominican males into the prevailing standards of masculine behavior. He posited that masculinity is a ‘totalitarian’ regime that controls the lives of Dominican boys and young men. De Moya used participant observation and interviews with men and women to identify the ‘rules’ associated with being a ‘normal’ boy in the DR including, “He cannot publicly show fear of anything,” “He should not sob nor cry, even when hurt,” and “He should show a vivid and visible erotic interest in all females who come close to him when he is with his peers.” (de Moya 2004) (p. 73–74). These behavioral ideals are instilled in young Dominican boys and enforced by others through punishment and shaming during youth and adulthood. As de Moya (2004) states: “Dominican males are socialized in a strongly restrictive and prohibitive environment, which surely cripples their spontaneity, authenticity, and joy, and produces hypocrisy and neurosis.” (p. 73). Thus, these rules not only stifle men, but may also cause a considerable amount of stress as they attempt to meet the rigorous standards of manhood. Pleck (1995) refers to the effects of this stress in his Masculine Gender Role Strain paradigm. Those men who do fit neatly into the masculine ideals may feel stress to maintain that status, and those who do not fit may feel the same stress as well as discrimination and shame related to not fitting the ideal.

While de Moya’s research focuses on a singular dominant ideal masculinity, other scholars within the DR and the region have identified two distinct ideals that are often in conflict with each other. This idea was first proposed in the region by anthropologist Peter Wilson (Wilson 1969, 1973) and later applied in Jamaica by Whitehead (1984). Wilson’s (1969) framework posits that men are subject to two interconnected value systems that he calls respectability and reputation. A man’s reputation is judged by his male peers and depends on his ‘masculine activities.’ The ‘masculine activities’ include sexual prowess, athletic competition, strength, seducing women, and fathering children. A man’s respectability, on the other hand, is judged by the entire society and tends to be based on European middle-class values (stemming from norms diffused during colonization). To be respectable, a Caribbean man needs to conform to the rules set by the church and government, as well as work hard, provide for one’s family, and participate positively in the society. Wilson notes that “both together make up a single system” and that they are “dual and contradictory” (p. 118) (Wilson 1974). Other scholars have similarly noted competing gender norms – such as the casa/calle (house/street) norms in the DR (Kerrigan et al. 2001) and homosocial/heterosocial social spaces in Mexico (Hirsch 2009). Men are socially rewarded for being both respectable and reputable and thus must fulfill both norms, even when they conflict. In terms of health-related risk behaviors, the reputation (and calle/homosocial spaces) are where group dynamics exist that facilitate promote sexual risk behaviors and other potentially harmful behaviors such as violence and alcohol abuse (Hirsch 2009, Kerrigan et al. 2001).

Our team’s previous empirical research with men in the DR has explored several dimensions of the relationship between men’s social networks and risk-taking behaviors. A mixed-methods study with male steady partners of female sex workers in La Romana, DR found that men’s sexual risk-taking was influenced by their perceptions of their peers’ risk-taking and the social influence exerted by those peers through social network interactions (Barrington and Kerrigan 2014, Barrington et al. 2009). We subsequently conducted a qualitative exploration of men’s peer group relationships – focusing on male peer groups and homosocial spaces – and found that most men lacked trusted friendships and many avoided friendships due to perceptions that peers would pressure them to behave in ways they did not want to (Fleming et al. 2014). We also found that men’s sexual behaviors and willingness to get tested for HIV is, in part, shaped by concerns of projecting a masculine image of strength to their social network (Fleming et al. 2015, Fleming, Barrington, Powell, et al. 2016).

These theoretical perspectives and our previous research indicate that men’s social interactions play a crucial role in influencing men’s behaviors in the Dominican Republic. However, we lack a nuanced understanding of how men perceive and describe these social interactions and the specific mechanisms by which masculine norms influence men’s sexual and violent behaviors. The current study aims to fill these gaps.

Methods

Study Setting and Context

We conducted in-depth interviews with thirty men in two cities in the DR: Santo Domingo and La Romana. Santo Domingo is the capital and financial center of the DR and has an estimated population of 2.2 million people (Consejo Nacional de Poblacion y Familia 2010). La Romana is the third largest city in the DR with a population of approximately 250,000 (Consejo Nacional de Poblacion y Familia 2010) and is located on the southeastern coast near many popular international tourist destinations. The surrounding areas are also home to a large Haitian-descendent community who live in bateyes and work in sugar production. We conducted our research as part of a larger study, which aimed to assess the feasibility of offering voluntary adult male circumcision as an HIV prevention strategy in the context of primary care settings in the DR (Brito et al. 2009, Brito et al. 2015, Brito, Luna, and Bailey 2010, Fleming, Barrington, Pearce, et al. 2016, Brito et al. 2017).

Recruitment and Data Collection

Our sample of thirty men was drawn from men who attended their follow-up visit for the parent study (n=362). The parent study used referrals and community outreach to find men who were 18–40 years old and were willing to undergo a circumcision. To reach a sample at heightened risk for HIV, female sex workers in both sites were asked to refer their sexual partners and in La Romana one recruiter was dedicated to recruiting men from nearby bateyes (Haitian descendent communities with a high HIV prevalence relative to the national prevalence). Follow-up visits (6 to 12 months after circumcision) for the parent study occurred between July 2013 and March 2015. We conducted in-depth interviews with all available men that came to their follow-up visit in May or June 2014, until all 30 interviews were conducted and the study team determined that we had reached saturation of themes. Men were reimbursed for their travel to the clinic (approximately 10 USD). Interviews were audio-recorded and conducted by the first-author in Spanish using a semi-structured interview guide. The interviewer is a white male in his thirties with experience conducting qualitative interviews with men in Latin America on topics of gender and masculinity; he is a fluent non-native Spanish speaker. Apart from questions related to men’s experience in the parent study, the interviews focused on three overarching questions: (a) how does the man define manhood in the DR?, (b) to what extent does the man want to be perceived as masculine by important others?, and (c) how do interactions with other men shape his own behaviors? All study procedures and protocols were approved by the Institutional Review Boards at the University of Illinois at Chicago, The University of North Carolina, Chapel Hill, and the Instituto Dermatológico Dominicano y Cirugia de Piel “Dr. Huberto Bogaert Díaz” in Santo Domingo, DR.

Data Analysis

Qualitative data analysis was iterative, starting with the completion of the first interviews and continuing throughout the data collection and writing process (Gibbs 2007). After each interview, the first-author wrote field notes about the interview and memoed about notable things the participant said or did (Emerson, Fretz, and Shaw 2011). Interview questions and probes were modified in response to observations from early interviews.

Audio recordings of interviews were transcribed verbatim in Spanish (McLellan, MacQueen, and Neidig 2003). After transcription, the first-author read through each transcript while listening to audio to identify key themes and stories and discussed preliminary findings with co-authors and the study team. For each participant, the first-author wrote a brief summary of each participant using available details from the their life and then wrote analytic summaries of what the participants said related to key areas of interest (e.g. competition, meanings of manhood, interactions with peers) (Sandelowski 1995). This process served to contextualize the meanings of manhood and other key concepts within the life of individual participants.

Subsequent to writing these summaries, we developed a codebook with deductive codes derived from the interview guides and inductive codes based on themes/ideas identified in our memos and summaries (Gibbs 2008). For example, deductive codes included ‘meanings of manhood’ and ‘violence’ and inductive codes included ‘humiliation’ and ‘selling yourself.’ We coded the transcripts using the Atlas.ti software (Atlas.ti 2012). The code outputs for key themes were used to systematically assess and deepen our understanding of ideas in the summaries. Using the narratives and code outputs, we prepared matrices for the analysis of patterns across the study population and for comparisons between sub-groups (for example, older men vs. younger men, married vs. single, La Romana vs. Santo Domingo, Haitian-descendent vs. non-Haitian descendent) (Miles and Huberman 1994). We integrated memo writing throughout this process to facilitate the interpretation of the data and to provide an audit trail of the analysis to document our interpretations (Saldaña 2009). After reviewing all memos, analytic summaries, and matrices, we identified prevalent narratives and themes that responded to our research question. Findings are described below using illustrative quotes with pseudonyms; in the results section we operationally define the terms common, many men, or men often as referring to more than half of participants, and some or few men to refer to themes reported by less than a quarter of participants

Results

We interviewed 30 men, 15 men in each study site, between the ages of 20 and 40. Most men were partnered, employed in either the formal (e.g. working for a business) or informal labor market (e.g. street merchant), and had at least secondary education. We first describe how masculine norms emphasizing competition shaped men’s interactions with their peers, and then how this competition is dependent on social context. Finally, we demonstrate how this competition – and specifically men’s fear of being humiliated and social pressure to respond to instances of humiliation – shaped men’s decision-making around sexual and violent behaviors.

Competition and the Importance of Social Context

Men described that being perceived as masculine was not simply about meeting certain expectations of manhood, but also that they additionally needed to successfully compete against other men. While Hector said he was fulfilling the masculine role of providing for his family, he additionally highlighted the importance of success relative to other men in his social network:

[You have to] always do things well…try to feel equal to them, if he tried to be more of a man than you, you can’t just stay behind him, you have to show him that you are equal to him, make him see, for example, that what he can achieve, you can also achieve.”

In addition to being a provider, Hector also felt the need to keep up with other men in his network. Thus, portraying a masculine identity was both about performing certain behaviors and about performing certain behaviors better than other men. What men competed about depended on their own personal priorities in a given social context, but typically reflected normative masculine characteristics such as a capacity to earn money, purchase material goods, attract or satisfy sexual partners, or have multiple sexual partners. Daniel, a 21-year old university student, commented that successfully competing required that men, including himself, could adapt themselves to emphasize different masculine characteristics (e.g. providing financially, aggressive, sexually potent) depending on their social context because different social groups placed varying degrees of value on each characteristic. He said a man’s portrayal of masculinity depended on “which group he’s going to sell himself to…there are different ways a man can be perceived, that’s what he ends up selling.” Many men’s comments highlighted the importance of context; below we use the story of Erick – a 20-year old street vendor who lived with his wife and young son – as a case example of how men described varying their behaviors depending on the expectations of a particular social group.

Erick lived in a close-knit community on the outskirts of La Romana and, like most men, worried about being able to provide for his young family: “I’m not going to feel content knowing that I have a son, a woman that aren’t eating well, that I can’t even buy a pair of shoes or nothin’.” While he was sincerely concerned about the well-being of his family, he also worried about the bad impression his neighbors would have if he was not adequately providing for his family. He said, “[I worry that] people are talking, humiliating me, making me feel lesser, ‘Look at him! He had his family, look now how he’s fallen, they can’t buy anything, they can’t eat well, and they’re getting too skinny’” He described how this fear of not being able to provide for his family – and fear of others gossiping about him – was a constant worry for him because this fear was related to his social status (e.g. ‘look now how he’s fallen’). His neighbors valued the provider masculine role and also devalued the calle [street] masculinity that emphasized violence and sexuality. When asked how he could demonstrate his masculinity to his neighbors, Erick responded, “Don’t be causing trouble in the calle so that no one talks [bad] about you.” He was concerned that if he got into fights or was known to have extramarital relationships he would lose social status among his neighbors. Erick articulated that his neighbors valued men that were responsible fathers and provided for their families and he tried to adapt his behaviors accordingly.

While his neighbors were one important social group for Erick, his friends were also extremely important in his life. He described that he and his group of friends grew up together and they were like family to him. Despite this familial intimacy Erick had with his friends, he said that there were situations when he needed to use violence to demonstrate his masculinity to them:

“There are always people that think they are more manly than you, they start getting fresh [confrontational] and stuff, you [perpetrate violence] so that you aren’t standing there with your arms crossed, so that you can demonstrate to him that you, too, are a man…That’s what happens with this type of violence. When you have five or six friends and you want those friends to respect you, you’ve got to prove that in front of everyone you are more than them. [You can do that] through violence.”

Erick’s friends expected him to use violence for instances when other men were confrontational and challenged his masculinity. For Erick, the social value of perpetrating violence depended on his context: it inhibited his ability to compete for social status among his neighbors but enabled him to gain social status among his friends. This contradiction played out in the lives of many men in our study who each belonged to various social groups (e.g. work colleagues, neighborhood, friends, church members, etc.) with different behavioral expectations.

Humiliation is a Key Element of Competition

These conflicting norms and the importance of successfully competing with other men to gain social status caused men to worry about being humiliated. Men used the word ‘humiliation’ to describe instances where their status, value, or respectability was called into question; typically these were direct threats on their manhood. Thus, it was a tool for competition since instances of humiliation severely restricted a man’s ability to successfully compete with peers. These humiliations were, by nature, public affairs that typically resulted in their social network members talking negatively about the man and were related to the normative characteristics of manhood discussed above (e.g. sexual prowess, earning money, competition).

Men referred to examples – often occurring at drinking establishments – where another man would bump into them, shove them, or say something to humiliate them in front of their friends or girlfriend/wife. Female partners could also humiliate men by not showing sufficient deference in public. Benito describes one example of another man being confrontational when he was with his girlfriend:

“I was with my girlfriend buying some sandwiches and three guys passed by my side and I accidentally ran into one of them. I turned around and said, ‘Excuse me’ and…the guy got aggressive and he poked me like this in the chest [he gestures a forceful poke] in front of my girlfriend. That’s humiliating! He did it precisely to humiliate me so that my girlfriend would see that she was with a coward.”

This type of humiliation was considered a challenge to men’s status because it was emasculating to be disrespected.

Men’s sexual relationships with women were another potential source of losing respect and feeling humiliated. Most men said that the biggest humiliation would be if a man’s wife or girlfriend was unsatisfied sexually or was cheating on him with another man. Edwin, a 39-year-old man who had been married for 22 years, described why it was important for him to satisfy his wife:

“[If] I don’t make my wife satisfied, she’s going to satisfy herself somewhere else, that’s the problem, you know? I have to try and satisfy her so that she doesn’t leave me for someone else.”

For Edwin, if his wife cheated on him, that would be a signal for him and for others in his social network that he was not satisfying her sexually. A cheating partner was considered the ultimate form of humiliation because it indicated a failure to fulfill one of his obligations as a man. Men described that ‘lasting long’ (i.e. length of time between penetration and ejaculation) was a marker of whether or not a man could satisfy his wife. Luis, a 21-year-old unemployed man who lives with his parents, described how conversations with friends about ‘lasting long’ caused men to worry about being humiliated during future sexual encounters:

“Sometimes you hear so-and-so saying, ‘no, I did this and that and I lasted a half hour [having sex], I lasted 20 minutes.’ [and you think] ‘So-and-so lasted a half hour? But I can’t even last 5.’ So you worry and try to figure out what’s going on, what’s the normal time to last?”

Luis’ curiosity about the “normal” time to last reflects his need to compare himself to others but also reflects the somewhat mythical nature of men’s sexual performance given that it is typically a private behavior not directly observed by others. Antonio, a 33–year-old married man with two kids, spoke about how this could lead to humiliation:

“Women can start talking, so that worries a man that they’ll say something about him, that he’s a ‘good-for-nothing’ man, and that you don’t make your woman feel good in bed. These things can cause a woman to look for other partners, you know? This [gossip] happens a lot and it worries men…because everyone is going to look at you as a joke.”

Again, even though sexual behaviors are typically private between two partners, this gossip about sexual performance was common and allowed members of men’s networks and their potential sexual partners to assess the man’s sexual capabilities – an indicator of his masculinity. Antonio’s comments emphasize how central a man’s sexual performance – and specifically capacity to satisfy one’s partner – is to a man’s social status and ability to avoid being humiliated.

Responses to Humiliation

Men’s responses to this humiliation shaped their sexual and violent behaviors. While a few men said they were able to ignore instances of humiliation, most said that a man must respond or react when humiliated. Benito described that a man needs to respond in order to ensure that he does not lose status:

“The man that lets himself be humiliated by another man loses his value in front of everyone else. He loses respect, or at least what they understand is respect, in front of everyone else. So, if a man doesn’t respond to a humiliation, he can lose his value as a man.”

Responding to an instance of humiliation is about saving face, recouping one’s masculinity, and ensuring that social status is recovered. How men responded to instances of humiliation were important for their sexual and violent behaviors; below, we describe three common responses – (1) perpetrating physical violence, (2) humiliating the other person, and (3) taking actions to prevent it – and their implications for behaviors.

First, the most commonly described way that men responded to humiliation was with physical violence. Felipe, a 22-year old married man, said:

It’s really common for guys to respond with violence, it’s rare that someone humiliates you and you can stay calm. No, you have to do something to get even because you feel bad about yourself because of what the other person did.”

This physical violence perpetration allowed men to ‘get even’ and recoup their masculinity. In the case of Benito who was humiliated by a group of guys in front of his girlfriend (described above), he violently threatened them – “I showed them my gun” – to scare them off and show them he was not a coward.

Men also commonly reported that perpetrating physical violence against women was often in response to humiliation from their female partners. Jose said, “A man becomes violent because a woman says, ‘you’re a good-for-nothing, I don’t feel good when I’m with you,’ so that causes conflict.” While only a few men seemed to express tolerance for physical violence against women, men described perpetration of physical violence against women as a common response from men in their community to instances of humiliation from women. When physical violence perpetration was used to respond to humiliation, it represented the easiest, quickest, and most obvious way for a man to demonstrate his manhood and superiority to others.

It is important to note that men’s decision to use or not use physical violence in response to humiliation depended on the context and the potential consequences. Felipe – the man who described the importance of violence above – described how men had to balance different priorities when considering their use of violence in response to humiliation. He mentioned that he was humiliated by his bosses at work: “they always look for some way to humiliate me or make me feel smaller than them…they are like, ‘listen, I’m much better than you, you are nothing,’” Felipe went on to recount his thought process about how to respond:

“You can humiliate me in my job and I won’t do anything because I’ll lose my job, but, truthfully, I feel humiliated… But, if in the calle [street] you humiliate me, I’ll grab you and hit you with something.”

In this case, Felipe prioritized earning money and providing for his family rather than demonstrating his capacity for violence and aggression. His workplace social environment called for different behavioral norms and expectations for men than the calle environment.

The second potential response to humiliation – humiliating the other person – allowed men to avoid the potential negative consequences of perpetrating physical violence. Men who used this strategy criticized and/or perpetrated emotional violence against the person who originally humiliated them which allowed them to recoup social status by calling into question the social status of the other person. For example, if a woman gossiped about a man’s sexual performance, the man may spread negative rumors about her. Benito said that if a man chose not to respond with violence to women’s insults about his sexual prowess, “he’ll insult her behind her back to try and humiliate her worse than he was, I mean, he’ll say that she smells bad down there or something like that.” This retaliatory response allowed men to respond to the humiliation and recoup their masculine status while avoiding the potential negative consequences of perpetrating physical violence.

The third strategy was preventing or minimizing instances of humiliation, which also had implications for their behaviors. Men who wanted to prevent humiliation related to confrontations with other men said they avoided bars or nightclubs, large groups of friends, and/or drinking alcohol. In contrast, men who wanted to prevent humiliation related to their sexual performance used several behavioral strategies to minimize or prevent humiliation. First, some men commented that they might preemptively change their sexual behaviors in order to avoid being teased. Pedro, a 35-year-old man with a steady job in the tourism industry, spoke of his decision when he was younger to start having sex with sex workers:

“I went out with friends, we paid [to sleep with] women, we were in that environment…It’s psychological, I felt like if I didn’t do what the others were doing, I wasn’t normal…If I were to say ‘no’, I worried what they would think of me.”

He modified his sexual behaviors as a younger man because he wanted to avoid feeling humiliated in front of his peers. Second, as an alternative to changing actual sexual behaviors, some men also exaggerated the truth or deployed lies to safeguard their sexual reputation. Arturo, a 28-year-old married man, provides an example of this: “I make something up to make myself look good during that moment of conversation [with friends]…I could say, ‘I was with a woman in a hotel, and Wow! That woman came and came.’ Something like that, a lie.” These lies allowed these men to avoid losing the increased social status that was associated with demonstrating sexual prowess. Finally, some other men reported that if they failed to sexually satisfy a partner, they sought new sexual opportunities to prove themselves again. Emilio, a 21-year-old construction worker, said that “faced with this type of humiliation, a man will try to grab that same chick that started to talk crap [about his sexual capabilities] and do it with her again so that she can see that it was just only that one day…[or] they’ll try to find other women to prove themselves.” Attempting to have sex with the same sexual partner or find new partners offers the man an opportunity to satisfy the woman and shift the negative gossip about him. The existence of multiple behavioral strategies to combat humiliation related to sexual prowess emphasizes the salience of this factor in shaping men’s sexual behaviors.

Discussion

We found that the relationship between masculine norms and men’s sexual and violent behaviors is primarily explained by male competition and avoiding humiliation in our sample. Men interviewed who successfully navigated how and when to emphasize certain masculine characteristics or behaviors were able to avoid being humiliated and losing social status. However, success was ultimately defined by men’s peers who were aiming to improve their own status and took advantage of opportunities to humiliate other men. These dynamics emphasize the fragile nature of being perceived as masculine in the Dominican Republic.

These findings align with previous research that has emphasized the fragility of masculinity (i.e. Precarious Manhood) and that the anxiety it produces is associated with aggression and sexual risk behaviors (Vandello and Bosson 2012). The concept of Precarious Manhood was formalized through the research of Vandello and colleagues (2008), but the idea that men are constantly needing to prove their masculinity has been highlighted by other masculinities scholars (Gilmore 1990, Kimmel and Messner 2001, Pleck 1981). Vandello and colleagues demonstrate through empirical research with men in the U.S. when men feel their masculinity is challenges, they respond with aggression (Vandello and Bosson 2012). Our findings also aligns with research on the culture of honor in southern United States which highlights that perceived slights against men must be responded to with violence to preserve one’s reputation (Nisbett and Cohen 1996, Cohen and Nisbett 1994). Men in our study who were humiliated grasped for relatively quick responses such as sex with a new partner or perpetrating violence in order to emphasize their masculinity and recoup their social status. Thus, men’s competition and humiliation have implications for men’s behaviors, their health outcomes, and the health of their partners and communities.

Men did not perform a singular coherent configuration of masculine behaviors, but rather adapted to each context and varied their performance of masculinity (Butler 1993, West and Zimmerman 1987). A masculine behavior in one social context (e.g. restraining oneself from violence perpetration) could be deemed as unmasculine in another context and thus a man is rarely free from potential humiliation (Fleming, Andes, and DiClemente 2013, Cohan 2009, Courtenay 2000). For example, some contexts required men to restrain themselves from violence and other contexts encouraged violence perpetration. This variation in masculinities is similar to the theoretical concepts of casa/calle, homosocial/heterosocial, and reputation/respectability in that it recognizes that there is not a singular masculine norm (Hirsch 2009, Kerrigan et al. 2006, Wilson 1969). Connell’s theorization of multiple masculinities highlights that different groups of men (e.g. working class men, gay men) each have their own configuration of masculinity (Connell 1995). While this concept emphasizes the group-level variations in masculinity, our findings – and the ideas of casa/calle, homosocial/heterosocial, and reputation/respectability – indicate that multiple context-specific masculinities may also be operating within individual men. For example, the man (Felipe) in our study who chose to back down when being humiliated by his bosses chose to prioritize his ability to provide for his family rather than prioritize his ability to demonstrate his strength and propensity to defend himself. Though his deference to his boss protected his economic livelihood, it also resulted in lower status at work and feelings of frustration and sadness. Situations like these can cause men anxiety, as men are actively concerned about their ability to portray a masculine identity.

This anxiety and concern about being able to demonstrate masculine characteristics is described in Pleck’s Masculine Gender Role Strain theory. Pleck postulates that cultural standards for masculinity exist, and that socialization encourages men to attempt to live up to them. He also highlights that masculine gender norms can be conflicting and inconsistent which causes men to worry about their ability to fulfill norms (Pleck 1995). Pleck describes several ways that this can result in negative outcomes for men. First, men who are unable to achieve gender role expectations may suffer from low self-esteem and other psychological consequences (i.e. gender role discrepancy). In our findings, humiliation results from men being unable to meet the gender role expectation and we also found that men reported feeling bad about themselves in such instances. Pleck also describes that men who have been able to achieve gender role expectations may result in harmful health behaviors because the gender socialization process has caused them to fear transgressing masculine norms (i.e. gender role trauma) (Pleck 1995). In our data, we see that men potentially harm themselves (e.g. adopting violent behaviors or risky sexual behaviors) in an effort to adhere to masculine norms in a given context. It should be noted that our data also find support for the fact that men’s concern about being perceived as masculine also sometimes encouraged them to avoid violence and adopt other seemingly health-promoting characteristics like working and providing for one’s family. Overall, the concepts of competition and humiliation are key factors for understanding how masculine gender role strain works to influence men’s health behaviors.

The field of study focusing on masculinities and health has largely ignored how masculine norms – and the dynamics of male competition – can prevent men from engaging in risky sexual behaviors or violence perpetration. We showed that men use both violent and non-violent behaviors as strategies to demonstrate their masculinity. Our data, unfortunately, had no information on whether or not men used sexually protective behaviors (e.g. abstinence, condoms) as strategies to demonstrate their masculinity. Future research needs to better understand how competition between men might be health-promoting across a range of behaviors and outcomes. Ultimately, men need to feel empowered to adopt non-violent behaviors and not fear that non-violence may appear unmasculine or inappropriate to certain members of their social networks. In some settings, women increasingly have a broader range of acceptable behaviors and life choices due in part to public health interventions that empowered women and modified their structural environment (Rosenfield 2000, Kim et al. 2007, Grabe 2010). Similarly, more men need to feel that it is acceptable – even to friends in the calle – to respond to humiliation in healthy or non-violent ways.

Given the importance of competition, health interventions that intervene on gender (e.g. gender-transformative interventions (Dworkin, Treves-Kagan, and Lippman 2013, Dworkin et al. 2013) should not only consider the harmful effects of the hierarchy between men and women, but also the hierarchy and competition between men. Health programming has spent decades attempting to dismantle the hierarchy between men and women due to its detrimental effect on women’s health (Rosenfield 2000, Kim et al. 2007, Grabe 2010). The same effort needs to be made to reduce status hierarchies between groups of men that can encourage competition and humiliation (Dworkin, Fleming, and Colvin 2015). Often, interventions targeting masculinities aim to encourage men to adopt child-rearing tasks or reduce their violence against women (Hatcher et al. 2014, Van den Berg et al. 2013). But, interventions can also begin to breakdown hierarchies between men by also asking men to challenge the idea that non-violent or sexually impotent men are failures as men. Elements from the interventions “One Man Can” and interventions undertaken by the Family Violence Prevention fund utilize some activities about competition between men, however these efforts should be expanded and more widespread. Such efforts will begin to neutralize the pressure men feel to belong to a specific type of masculinity to avoid being humiliated and losing social status.

Finally, future research needs to acknowledge that masculinities are specific to social contexts. Most current research on masculinities and health utilizes measures to characterize the type of masculinity that a man endorses or adheres to (Shattuck et al. 2013, Santana et al. 2006, Noar and Morokoff 2002). For example, research within the field of HIV relies on men’s normative beliefs about sexuality (e.g. should men have multiple concurrent partners?) (Pulerwitz and Barker 2008, Archer 2010). But, this assessment ignores that masculinity – and its corresponding beliefs and behaviors – is context-dependent and that multiple masculinities can and do coexist within the same man. Measures of gender ideology may need to employ vignettes or other innovative measurement techniques to assess context-specific attitudes (Finch 1987). Additionally, measuring constructs like Gender Role Conflict may be more useful than measuring adherence to norms, since it gives a better idea about men’s internalization of gender norms and how concerned they are to adhere to those norms (O’Neil, Helms, and Gable 1986, Gottert 2014).

Limitations

Our study findings and conclusions should be considered with some limitations. First, our participants were voluntarily enrolled in a study of male circumcision. The sample of men who opted to receive a circumcision may differ substantially from a more general population of men. Second, our sample is small and primarily consists of low-income and low-education men. Thus, we are unable to tease apart differences between sub-groups. The issues described in our paper are likely to be different for Dominican men with higher education, higher income, or other factors. Third, this study is exploratory and theorizes – and provides empirical evidence for - the mechanisms by which masculine norms, competition, and humiliation contribute to sexual and violent behaviors. While our data describe these mechanisms, future research is needed to establish any causal relationship. Finally, the data were generated through conversations by participants with the interviewer and the interviewer’s identity and characteristics likely influenced the types of responses we received; though we don’t consider this a limitation, our data should be interpreted in light of this fact.

Conclusions

Health researchers and interventionists have made great strides in acknowledging, considering, and incorporating norms of masculinity into contemporary studies and health promotion efforts with men. Continuing this forward progress in men’s health – and the health of their partner and families – requires incorporating social dynamics, such as competing gender norms, into interventions that address male competition and empower men to overcome these negative social influences.