In total, we interviewed 32 men (average age: 20.5 years). Seven men were recruited from clinical (youth clinics) and six men from non-clinical sites (community centres and colleges) using posters and 19 men from online social networking sites (such as Facebook). All participants had previously had sex (oral, anal or vaginal, or all three). See Table 1 for the characteristics of the participants.
The conceptual findings are divided into two thematic sections that exemplify the discourses men employ to talk about sexual health: (i) guy talk and (ii) manning up. We use quotes from participants to illustrate these themes and to further contextualise how they described the discussions that they have with peers and sex partners about sexual health.
We asked participants to describe the situations in which they were able to discuss their sexual health with peers. Most participants explained that their discussions about sex typically consisted of descriptions about their sexual encounters (whom they had sex with and what sex acts they engaged in) and several participants referred to this as guy talk. Few said they had ever talked about sexual health-related issues (such as STI testing or condom negotiation). As Milo, a straight 19-year-old East Asian man, explained, when he and his friends talk about sex, it is:
just guy talk, I guess. Whatever. Like, if I had sex with a girl last night, I’ll like call my buddies and be like ‘Yo, last night was fun!’ and he’d be like ‘Oh what’d you do?’ Stuff like that. But we don’t really talk in terms of like sexual health [emphasis added to indicate Milo’s voice inflection], like getting STI tests.
As the inflection in Milo’s voice indicates, sexual health was frequently described by participants as a side issue that distracted from or diluted the details of their discussions about sexual conquest and pleasure. In this way, the men in our study discursively emphasised masculine sexual performance (that is, discussions about who did what to whom is afforded priority during discussions). This discourse also positions sexual health discussions as tied to help-seeking behaviour (getting STI testing) – a subject not conventionally included in guy talk. As a result, notions of idealised masculinity are discursively linked to sexual prowess and virility and, inversely, discussions about health or illness are associated with notions of weakness (feminine stereotypes), thereby constituting a discourse that precludes discussions about sexual health or illness.
Some participants explained that gay men can more freely or openly engage in conversations about sexual health (for example, because they are assumed to ‘talk about sex all the time’). Although our data revealed a more complex set of practices, the gay men in this study were more likely to describe having talked about sexual health, but only with their gay friends. As Bill, a 22-year-old Euro-Canadian gay man, said:
For gay guys like me, my best resources are my gay best friends. Gay guys talk about sex all the time. Sometimes it’s just, you know, a story ... But if you want advice on something, you’re probably going to get it. Because somebody probably experienced the same thing.
Conversations about sexual health among gay men were also aligned to a dominant masculine discourse around men’s talk relating to sexual performance where descriptions of sexual acts and partners are used to signal virile gay masculinities, marking hierarchies within those masculinities. Several gay participants also acknowledged that heterosexual men tend to focus their guy talk primarily on their sexual encounters (but with women), relying on the use of humour and derogatory remarks to relay their stories. As Bill, the aforementioned 22-year-old gay man, acknowledged:
It’s like they [heterosexual men] just make fun. It’s not sexual health ... My best friend is straight and I hang out with straight guys all the time. When they start talking about sex, I slowly turn myself off ... I don’t want to hear them talking about pussy ... Girls are gross ... I don’t want to hear a string of short stories about their ‘times with women’. And, then, they’ll come up with some kind of gay, orgy fantasy. And, I’m just like [pause]: ‘I don’t even dream about that shit!’ Where do they come up with these things?
Talking about sexual encounters (including fantasies about gay sexual encounters) in ways that reify hyper-masculinity tended to dominate participants’ accounts (even in groups that include a mix of gay and straight men). Revealed here is an example of how patriarchal power can be (re)produced by a set of ritualistic masculine practices (hyper-sexualised hegemonic ideals) which can also be operationalised by (heterosexual) men’s discourses to include the subordinated ‘other’.
Some men described experiencing negative social repercussions if they discussed sexual health. By breaking the taboo, those who broached the topic of sexual health with their men peers were frequently subjected to ridicule. For example, Christopher, a Black 17-year-old straight man, expressed frustration with the teasing he was subjected to by peers after he tried to discuss sexual health. Christopher explained that he has since avoided talking about sexual health, for fear of further mocking:
Well ... [talking about sexual health] with guys, no, because I don’t know where the conversation is going. I don’t want it to be that I’m going to ask an intelligent question, and at the end of it, I’m being made fun of for being a virgin or something silly like that ... It’s going to be twisted around and then I hear from the next girl I’m trying to date that she thinks I’m gay or that I might have an STD.
Christopher’s explanation reveals the masculine discourses and codes that filter, censor and govern men’s sexual health talk. At risk in the moment and in the aftermath of such disclosures are gossip and rumour, invoking a subordinate (gay) or suspect (diseased) masculine status. As a result, Christopher said that he had learned to avoid discussing sexual health – a strategy rooted in silence, thereby prioritising the avoidance of potentially emasculating ridicule and damaging rumour. Christopher’s explanation also demonstrates the ways in which discourses that prioritise heterosexual desire and essentialise masculine talk as strong and confident can create barriers for men engaging in discussions about sexual health. In fact, for several participants, our interview provided the first opportunity to discuss and reflect on issues related to their sexual health. Christopher explained that the primary reason for participating in the study was to have the opportunity to confidentially discuss and learn more about sexual health issues.
Several participants explained that conversations about condom and contraception negotiation were particularly difficult to have with sex partners because issues of trust and fidelity would inevitably arise. As a result, participants explained that they avoided these discussions, thereby deferring to their partners the responsibility of initiating relevant conversations and action(s). For example, Johan, a straight 22-year-old Euro-Canadian man who was not monogamous, explained that, while his preference was to use condoms, he often felt uncomfortable discussing this topic with sex partners:
I just find myself not making good decisions around it [using condoms] more often than I’m comfortable with. It – the pleasure is definitely a huge part of it. I think another part of it might be that I – I don’t like talking about ... It is just ... [pause] Like, I don’t want to stop to necessarily bring it up – like if I bring it up, it’s like, almost like ... Talking about condoms is almost like discussing having sex, and like ... you know, if it’s just happening, then like, I don’t wanna feel like I am having to discuss it. ... I really do appreciate it when girls bring it up ... because yeah, just, it takes that pressure off a bit.
Here, the participant positions sex as being substantially a realm of non-rational experience that is also valued because it does not involve everyday types of thinking. Related to this, negotiating safe sex through condom use is positioned as more likely to emerge from the female partner as a by-product of femininised virtues that value health more than sexual pleasure. As a result, initiating this conversation might reveal Johan as being concerned about safety rather than spontaneity and pleasure. While acknowledging that he should care about condom use, Johan’s silence renders him complicit in sustaining dominant masculine discourses around pleasure, hedonism and giving into his sexual needs. This discourse reveals the gendered power relations that place Johan in a position where he leaves it to his female partners to take care of sexual health decision-making.
A few men explained that, although it was difficult, they occasionally engaged in discussions about sexual health with their peers and/or sex partners (for example, STI symptoms or testing; notifying sex partners of potential infections). When asked how these conversations ‘played out’, participants explained that humour was the lynchpin to engaging in such discussions – especially when they had talked with male peers. When asked to describe how he discussed sexual health with his friends, Tyler, a 23-year-old straight Euro-Canadian, explained:
Tyler: Once in a while one of my friends will get with somebody very questionable and we’ll kind of poke him and prod him to go get, go get tested. [Chuckles] That does happen sometimes.
Interviewer: What do you mean by ‘questionable’?
Tyler: Um, well, first of all, someone we don’t know. Someone we may have heard that sleeps around. Somebody who insists on not using protection.
Interviewer: Okay. And how does the ‘poking and prodding’ go?
Tyler: Usually we tease him and tell him he probably has AIDS. It really gets him going.
By employing teasing humour in these conversations, the friend is encouraged to seek STI testing, while Tyler (and the wider group) implicitly disclaim they really care about their friend’s sexual health. Teasing humour can serve to prompt men to reflect upon, and perhaps recognise and reconsider ‘risky’ sexual practices, while not explicitly challenging key hyper-masculine performance indicators (sexual pleasure and conquest).
A few participants explained that they were able to discuss sexual health in a more serious way, but only with friends that they trusted deeply. Jameel, a straight 21-year-old man of Middle-Eastern ancestry, described how he discussed STI symptoms with his closest friends:
It depends on the background of the guys first of all and how long you’ve known the friends for. Like, I usually can’t talk to a friend that I’ve just met on campus for, like, a month or two. Usually I can’t talk about that with him. But I usually prefer to talk to my male guys that I’ve known for 6, 7 years that I’ve known like my brothers. So I just talk to them with my concerns and they usually come up with some advice and they’re usually, like, if I am concerned with some symptoms or if I’m just paranoid they tell me: ‘Hey, just calm down and go get tested. Don’t worry about it and hopefully it’s nothing serious.
For Jameel discussions about STI symptoms (and the like) could only be conducted with friends that he trusted ‘like brothers’. Jameel’s explanation reveals how deviating from the discourses constituted by guy talk (such as asking for advice or help about his sexual health) can only take place when specific criteria are met (with friends that he trusts while he is ‘paranoid’).
Manning up: talking about STIs and health
While most of the men in our study employed guy talk to filter out or govern discussions around sexual health and illness, some men described situations in which they engaged in a different kind of discourse, which several described and discursively positioned as a social practice that required ample courage. Jameel said that he would feel the need to talk with his friends about the experience of getting tested for an STI (albeit after he was treated and cured):
As time goes on, I think things tend to be less intense; so, I would actually let them know after a while that ‘Yeah, I’ve been diagnosed with that like several months ago; but, I’m getting treated or I’m under some kind of treatment’, and then would actually let them know. But at the instance, I don’t think I would be able to. I wouldn’t have the courage to tell them, yeah.
Like Jameel, most participants indicated that they would need time to muster the courage to break with masculine discourses around stoicism, invulnerability and the denial of illness, and several of the participants used the term ‘manning up’ to describe this process. Preparing to man up and speak more openly about sexual health problems (STIs) with friends and peers emerged as an important theme during the interviews, although most of the interview participants indicated that their first instinct would be to align with a masculine discourse where themes of autonomy and self-reliance trump the urge to talk with or seek the counsel or support of others. The process of manning up was most frequently invoked as a discourse when the study participants described situations where they had engaged in discussions with male friends about having had an STI.
Participants also positioned the strength and courage to man up as residing in particular actions. Zachary, a gay 22-year-old Euro-Canadian explained that when he had tested positive for STIs he had notified his sex partners directly rather than ask the health department to contact them (in BC clients have the option to do either):
My sexual partners, I don’t exactly know very well. I always try to keep ... I always try to contact them if I ever do come down with something. That’s hard. But they have that service available here where you can just give the clinic the phone numbers of the people and they’ll call, which is kinda good. But, I mean, really you should man up and tell them yourself.
Zachary’s characterisation of notifying his sex partners himself as an act of manning up seemingly contravenes dominant masculine discourses in which men deny illness and do not advise other men about sexual health. However, by manning up, Zachary repositions what it means to take responsibility for others’ sexual health by emphasising his decisive, honourable actions aimed at doing the principled and perhaps protective thing. Notifying sex partners (which in Zachary’s story is positioned as virtuous) is characterised as something that ‘real men’ have the power and control to do for greater good, with a reckless disregard for the implications and potential repercussions on their own masculine status. In privileging and performing this version of manning up, participants were complicit in sustaining a specific set of masculine ideals. They discursively positioned real men as dominant and capable, facing up to a problem for which they might be held responsible, amid steely resolve to withstand any potential conflict or estrangement (such as being blamed for the STI by sex partners). As Tyler, a 23-year-old straight guy, confirmed:
Tyler: Straight up. No. No e-mail, no doctor calling them.
Interviewer: So you wouldn’t prefer the doctor or nurse to call your sex partners?
Tyler: Hell no. No. Go tell them yourself. Quit being a pussy ... I think you should call them yourself. Really, I think you should implicate yourself. I think you should put it right out there, yeah. Uh, ‘I had sex with you. Um, if it wasn’t protected, I may have given you something’. Own up to it.
In being required by the state (that is, public health surveillance systems) to account for sexual illness, Tyler and Zachary’s explanations reveal the multiple considerations they face in deciding whether or not to inform their partners about the possibility of STI transmission. Tyler and Zachary reject the option of deferring responsibility to a public health nurse (in which they could remain anonymous to their partners – or, at the very least, distanced from their reactions) and instead take-up ‘manly’ discourses related to integrity and responsibility. In doing so, Tyler and Zachary position the partner notification process as a situation in which they must preserve their masculine identities.
Other forms of manning up emerged during the interviews, whereby feminine ideals (like caring and helping) were reshaped in more subtle ways to reflect masculine ideals (such as taking charge or being strong). Cody, a 23-year-old straight Aboriginal man, explained how he had helped his young cousin who was experiencing STI symptoms:
My little cousin, man, he had chlamydia and VD [gonorrhoea] and it was bad, man. It was Christmas time. I’m driving around looking for a clinic to get him fixed, man. That’s the pain he was in. Yeah, gonorrhoea, man, it fuckin’ hurt him. It’s like, ‘Aw, dude, man’. I found a doctor’s office that was open and they gave him the pills ... He was 16! He was 16 when he caught both of those diseases, man. Like the dude was in pain, man! ... He was like, ‘Yeah, I have something ...’. And I told him, yo, man, I just got rid of chlamydia myself. There’s pills for it, man’.
Here, Cody disregards the discursive conventions of guy talk and reveals his chlamydia diagnosis in order to empathise with his young cousin. This discourse also positions Cody as a fixer – a man who is strong and wise enough to take charge and handle the problem. Emphasising his capacity to man up in a crisis, Cody also told us that his best friend had recently come out as homosexual. He explained that he was able to support his friend through this process because he knew how to behave in difficult situations (pointing out that he had been hardened up by his difficult previous life experiences). Cody described himself as someone that others could rely on in difficult moments, especially in those circumstances requiring ‘straight up’ actions:
Just, everybody just thinks I’m cool, man. I’m a good guy to hang out with, like. I’m straight up, there’s no fuckin’ lying or anything. I’m straight, man, and you know? If I don’t like someone in the fuckin’ crowd, I’ll fuckin’ tell ‘em straight, ‘Yo man, you know, you’re being an asshole, man, you know? Like, fuck, no one likes you’ ... Plus I stick up for my friends ... I’ve seen some fucked up things, man. Especially for my age, too, man. I can’t believe all the shit, but hey man, out of the fast style, the lifestyles. I’ve done a lot of things in my life and probably will do more.
Cody’s discourse demonstrates a complex packaging of dominant masculinity to distil particular virtues in what it means to be a real man. He takes pride in being a man strong enough to transcend heterosexist stereotypes (embracing his friend as a homosexual man). Cody also takes risks both in and around adopting behaviour associated with feminised traits (by caring about others and accepting and defending gay men); but, rather than having his masculinity questioned, he deploys a discourse that ultimately bolsters his ubiquitous hyper-masculinity. Whereas for ‘weaker’ men, these situations would present dangerous and emasculating risks, for Cody these performances are catalysed to elevate his masculine status.