Ruth

This chapter is about how women influence and talk about men and their health. By asking the broad question of whether women’s identities have anything to do with how men become healthy and ill, this chapter aims to show that these processes are gendered. Guatemalan immigrant women’s shifting gender identities due to displacement, migration, and resettlement profoundly influence how Guatemalan immigrant men "do" gender and "do" health (Saltonstall 1993). I outline these processes to contribute¾ both theoretically and methodologically¾ to a small but growing area of research that pays attention to how men and women talk about each others’ bodies, and how the very processes of talking about bodies shapes gender identity.

The analysis in this chapter is grounded in recent studies of masculinity that address the various ways in which men and women construct men’s identities (Gregory 1984; Gutmann 1997a; Kimmel and Messner 1998; Lancaster 1992; Saltonstall 1993). It follows anthropologist Matthew Gutmann’s claim that you can never truly study one gender (1997a). It argues that immigrant women’s shifting gender identities due to displacement and movement can influence how men see themselves¾ and how men act on these constructions of personhood¾ in their everyday lives. In his innovative ethnography of working class men and women in Mexico City, Gutmann focuses on clarifying the cultural relation that women have to men, to masculinity, and to changing male identities (1997a:834). Gutmann shows how masculinities develop and are transformed, and how masculinities have little meaning except in relation to women’s identities and practices (1997a:834). Whether women are present or not, argues Gutmann, women’s identities serve as a central point of reference for men in what it means to ser hombre (be a man) (1997a:836). I foreground these insights from Mexico City to provide a context for the following discussion of Guatemalan immigrant women’s constructions of men’s identities and health experiences.

Ana and I were drinking coffee in a café on a cool October evening in downtown Toronto. We were discussing her experiences of migrating to Canada from Guatemala as a young girl, and whether she considered herself to be "Canadian." She talked about how her ideals and beliefs were different from those of her close relatives, who insist that she is the most "Canadian" woman in the family. She agreed, but was quick to point out her strong allegiance to "her culture":

In certain ways, I do consider myself to be Canadian as well because I did grow up here and my ideals, my opinions on life are not necessarily what you would stereotype Canadian, but I’m definitely not Guatemalan. Although I do speak Spanish fluently, I’ve been quite proud of that, I’m very proud of the culture, I love the music. I have kept all of that. And that’s because of my parents. They insisted on that.

Ana demonstrates her "pride" towards Guatemalan culture by speaking Spanish and enjoying marimba music. Although she is "definitely not Guatemalan," she is glad that her parents have maintained aspects of what she considers to be Guatemalan culture. Ana’s sense of Canadianess or Guatemalaness, however, is not only articulated through the languages she speaks or the types of music she listens to. Our conversation about culture evolved into a discussion about gender and sexuality. She viewed her cultural or national identity as entangled with what it meant to be a woman:

In my thinking, my views, my direction in life I would be thought of as more Canadian than Guatemalan. Because I don’t feel that a women’s role is to grow up, get married and have children. I mean at my age, my aunts think that I am a spinster woman. They think I’ll never get married.

My mother wished I was married. But they have to understand that we’ve grown up in different ways: here it’s your career, you stabilize yourself first, and I think that’s important to me….And I’m not gonna conform to any ideals they have.

As a young, unmarried woman with career aspirations, Ana sees herself as more Canadian than Guatemalan. She cites the differences in generation and upbringing between herself and her close female relatives as key to this self-fashioning. Her refusal to adapt to their expectations about marriage and bearing children entrenches the cultural gap that she believes has formed between herself and her aunts.

Ana’s sense of personhood is also shaped by how she views Guatemalan men. Ana holds strong views about the roles of women and men, and thinks seriously about the kind of man she hopes to marry.

I vowed that I would never ever marry a man from Guatemala. As hypocritical, as damaging as that could be. But because of my experience with men from Guatemala I said "never again", hopefully [knocking on wood and laughing].

By pointing out that her decision not to marry a Guatemalan man may be "hypocritical" or "damaging," Ana hints at a sense of obligation to be attracted to Guatemalan men as a way to demonstrate her pride towards "her culture." The ambiguity of her position, however, is captured in her phrase "never again, hopefully." While Ana is strongly opposed to the idea of marrying a Guatemalan man, she feels a sense of duty to please her aunts and other family members by marrying a Guatemalan (or at least Latino) man.

Guatemalan men, Ana complains, lack career aspirations and like to drink. As a young, independent woman focussed on her career, she wants to marry a man who shares similar goals and who leads a sober lifestyle. Yet she is not entirely comfortable with this position. Throughout our interview she was careful not to "damage" her culture, to use her words, by speaking too negatively about Guatemalan men. Her statement about never wanting to marry a Guatemalan man was a source of humor throughout the interview. She knew it piqued my interest, and later in the interview she explained what she meant.

I should start off by saying that I am truly proud of my culture. But the first thing is I don’t like liquor. I’ve never acquired a taste for liquor, I don’t drink, I don’t like people drinking. And that’s one big, big thing that a lot of men have. They start off as very young, it’s accepted, it’s something they do. It’s not something that I’m gonna accept.

The other thing is their direction in life. I have goals. I’m 28 and I’m single for a reason. I have a career and it’s something that I’ve worked for. I want somebody who’s gonna share the same views. Unfortunately¾ and there’s always exceptions to the rule¾ most definitely in the Guatemalan society men don’t have direction. They’re happy with what they have, they can work paycheck to paycheck, and that is enough for them. That is not enough for me.

In this response, Ana simultaneously constructs her own identity and the identities of Guatemalan men she has met, lived with, or heard about. By fashioning herself as motivated, career-minded, and independent, she produces an antithetical image of the Guatemalan man: drunken, lacking direction, and perhaps overly social.

The purpose of introducing Ana at the beginning of this chapter is to highlight the ways in which identity is not an isolated "thing" that someone has or does not have. Nor are identities resolved or complete. Rather, they are always in process and therefore partial and contradictory (Yon 2000). While Ana insists that she will never marry a Guatemalan man, she can only "hope." At one moment proud of Guatemalan "culture" (language, music, and landscape) and at another moment ashamed of Guatemala’s "Third World" status and system of gender relations, Ana’s ethnic identity is not stable but rather fragile and open for (re)negotiation. Ana’s narrative also demonstrates how Guatemalan immigrant women construct the identities of Guatemalan men, both "at home" and in the diaspora.

Ruth and Carmen¾ as well as Juana, who will be introduced in the next section¾ emphasized their increasing roles as financial contributors to the family as a key influence on the identities and roles of men. These women held contrasting views on whether attitudes and behaviors associated with machismo were more or less prevalent in Canada than in Guatemala. Drinking, violent behavior, control over las mujeres (women, partners, wives), and being the sole economic provider in the family were considered to be forms of machismo. What I learned from these women¾ and which was markedly absent from my conversations with men¾ was that women’s increasing rights and security in Canada compared to Guatemala has resulted in a relative decline in macho behavior among Guatemalan immigrant men. Carmen described machismo as follows:

The Latin American men are "machista" because they like to be in control of their families, and in control of their women. They also think they have the right to hit the women if they don’t agree with them.

I then asked her if this sort of behavior was common among Guatemalan men in Canada:

I don’t think so because they know women are more protected it in this society and they are also very scared of the police force.

Ruth also believed that there is less machismo in Canada than Guatemala:

Machismo to me means that the man gives you orders all the time about how to raise the children, and about everything around the house. My opinion doesn’t count very much and the children have to follow his orders. Sometimes I think this style of life is good, and sometimes I think it isn’t, but most Spanish men behave this way.

Here you don’t see that situation very much because women have more protection.

Women have a lot of protection, but sometimes they stay with their man because of their children, their fears, and love at the same time. I think women have to take other decisions to have a normal life.

Carmen and Ruth’s statements about there being less machismo among Guatemalan men in Canada than Guatemala is particularly interesting when juxtaposed with the explanations provided by men in the previous chapter. Whereas many men attributed a decline in behavior associated with machismo to self-motivated efforts to become a "real" or "modern" man¾ without mention of the shifts in identity among their female counterparts¾ women argued strongly that better legal protection for women in Canada provides a check on macho actions. Becoming less of a machista, in other words, is not just men’s doing. It is one consequence of Guatemalan immigrant women actively taking advantage of larger spaces for political, economic, and social mobility in the diaspora.

This analysis illustrates that the process of (self) fashioning identities can neither be understood as an isolated act, nor as a process simply attributed to a larger context "out there." While individuals may not always view their shifting identities as the result of conscious political or social activity, they are no doubt influenced by the re-shaping of identities of people in their families, in their communities, in their news sources, and on TV. As Stuart Hall (1990:222) reminds us, "instead of thinking of identity as an already accomplished fact…we should think, instead, of identity as a ‘production’, which is never complete, always in process." The trick becomes, then, to discern how identity is constructed, how it is processed, in what settings it is produced, and for what audiences it is performed. By viewing identities as always formed and transformed in relation (Nelson 1999), we can begin to appreciate the complex ways in which Guatemalan immigrant men and women make and re-make identities in the diaspora.

Attitudes and behaviors associated with machismo were generally considered to have a negative impact on men’s health and on their social relations with women. In this view, macho men womanize, drink a lot, act violently, and ignore the problems in their lives. However, machismo was not always considered a bad thing. When I first asked Juana if there was anything positive about the attitudes and behaviors of machistas she jokingly replied:

Although Juana does work full-time as a cleaner, her joke refers to the image of the macho man who insists that he is the primary economic provider in the family, and who demands that his wife or girlfriend take care of domestic duties. At first glance this joke may seem simply tongue in cheek and not worth serous analysis, but it is suggestive of how Guatemalan immigrant women may see themselves in relation to the (stereotypical) expectations of macho men. This hint of sarcasm provides an interesting example of how Guatemalan immigrant women conceptualize their own social and economic positions in Canada via what Diana Fuss calls "a detour through the other" (in Nelson 1999:29).

Juana followed this joke with a more elaborate description of her personal feelings about machismo. Even though she feels that macho men are difficult to live with because they refuse to deal with emotional problems in a constructive way, she likes men to be "a little bit macho." She is fond of men who are (not too) jealous (celoso). She is attracted to this jealousy because it indicates a man’s love for and devotion to one woman.

I will give you my personal opinion. I like men who are a little bit "macho," I love to feel that he is in charge of the situation because I feel protected. I love to hear my husband’s suggestions, and I share with him my ideas, but I won’t tolerate his orders. I think you need a balance in a relationship and a confident husband.

I like to hear my husband say, "don’t wear that short skirt because I don’t like it," for example (laughter). It makes me feel like he worries about me and he doesn’t want to share me with other men. You have to be careful and be alert because some men are very jealous.

Juana also admired some machistas for their "strength" as hard workers. This strength is articulated both as physical capacity (being able to do heavy work) and emotional stamina (being able to work long hours with few breaks).

Juana’s description of the meanings attached to machismo illustrates the contradictory ways in which Guatemalan immigrant women construct the identities of men. There is not only ambiguity in the way men construct themselves, therefore, but also in the ways that women talk about and influence the lives of men. The various ways in which Guatemalan immigrant women view men¾ as stubborn, jealous, hard working, and able bodied¾ does not mean that these women are confused about who men are. Nor does it suggest that men are simply "whoever they want to be" and are not influenced by the social forces around them. Rather, to suggest that women construct men’s identities in multiple ways indicates the importance of understanding the particular historical contexts in which Guatemalan immigrants are positioned, and the complex ways in which these individuals fashion this context. Further, to emphasize that women view men as violent yet compassionate, and stubborn yet hard working is not to draw attention away from how men¾ consciously or not¾ reproduce dominant forms of masculinity that maintain political, economic, and social inequality between men and women in these global times.

The bulk of my conversations with women about Guatemalan immigrant men focussed on men’s health and how men become healthy or ill. The preceding discussion about women’s constructions of their own identities and those of men has aimed to foreground the importance of shifting gender identities for individual health. Only recently have social scientists begun to seriously engage the relationship between gender and health, as well as between gender and the utilization of health care (Courtenay 2000a; Freire 1995; Sabo 1998; Sabo and Gordon 1995). Moreover, while these studies have paid attention to how gender shapes conceptions of health, the body and health care, they have largely failed to address how processes of becoming ill or healthy challenge or transform what it means to be a man or a woman.

To give one example from Margaret Lock’s study of Greek immigrant women in Montreal (1990), she analyzes the experience of nevra, or nerves, among these women. Nervra¾ which, according to Lock, is more common among Greek women than men¾ is a somatized idiom of distress which Greek women explicitly link to the immigration experience and to a nostalgia for their lost heritage (1990:248). Although men’s health is outside Lock’s focus for her study, she does not problematize Greek men’s repeated insistence that their health is "alright," and their refusal to go to the doctor for anything less than life threatening problems (1990:241). Why is this the case? And what might thihs say about the connection between gender and help-seeking practices among immigrant men and women? Lock concludes that nevra is considered a "normal" part of everyday life for Greek immigrant women (1990:248-249). But what she doesn’t sufficiently address is that nevra may be precisely the result of not leading what her subjects consider to be a "normal" life. Further, this conclusion begs the question of how the "normal" is constructed by these women, and what an emphasis on the routinization of nevra says about personhood.

It is these sorts of questions that provoked my interest in talking to Guatemalan immigrant women about men’s health. Several themes emerged from my conversations with these women. First, each of the five women I interviewed believed that Guatemalan immigrant men tend to suffer from more health problems than women in Canada. Ana talked at length about the difficulties Guatemalan men face as a result of migration to a different country:

There’s been a lot of depression, discontent. A lot of men have a hard time adjusting to life here. Even though it’s easier in the sense that there’s more choice, it’s not as easy here because they’re no longer the sole provider. They’re not going to admit that life is hard here, and that maybe they miss their country. And so they drink. So they almost come hand-in-hand so to speak. But actually admitting that they’re depressed, you’ll never see that. You can see it but they will never admit to that.

To clarify her response I asked Ana if one gender tends to adjust to life better in Canada:

Women definitely adjust, cope, and persevere better than men here. I think it goes back to that cultural difference where men feel inferior to the rest here because in Guatemala they have everything, here they don’t.

Women become a lot more strong here; I have seen that….Here women are not in the shadow of their husband and because they know they have choice and opportunities here, they definitely deal with it better. They take advantage of it. Whereas men just choose to get a job and that’s it.

Carmen also stated that immigrant men tend to face more health problems than women:

I think women are healthier than men and they also die after them. Men work harder than women, they love to drink more and they don’t take proper care of their bodies.

Laura, too, briefly mentioned that although there are exceptions, refugee men tend to suffer greater social and health problems:

When families are in exile, women have the ability to adjust better to the new environment and men became withdrawn, sad, and lonely. They refuse to share their problems with other people.

Using a phrase which seemed to capture the health and immigration experiences of many men and women in this study, Ruth pointed out that men cannot salir adelante ("move on") as well as women:

It’s easier for [women] to adjust to their new situation. A lot of women have to go to work, sometimes, without really understanding what they have to do. But they know they have to try their best because they need to support their families. When people have children they need to bring money home. The reality is different for a lot of men in this country because it takes longer for them to adjust, and most of the time they end up on the street. I know of a lot of cases in which men that did very well in their home countries couldn’t make a living here. Adjusting to a new way of life and a new language is too much for them. They don’t know how to move on. They prefer to avoid it by resorting to alcohol. Our men are used to being in control of the family, and due to the new circumstances they feel lost.

During a discussion about alcoholism, Laura also believed that women’s greater responsibility towards children may be a cause of women’s relative healthiness compared to men:

It is very common for people in exile to become alcohol abusers due to all the problems and adjustment they have to face in the new society they live in. I think women become stronger because they feel responsible for their children and for their families.

These various responses to questions about how men and women learn to live in a new society provide insights into how gender and health are entangled. Ana emphasized that men are forced to seriously reconsider their roles and sense of self in Canada. Since men may no longer be the primary "bread-winner" in the family, they have to rethink their direction and goals in life. She explicitly links alcoholism with the experience of migration. According to Ana, not admitting that "life is hard" in Canada exacerbates the problem. She further explains that men¾ more so than women¾ "lose" part of their identity upon migrating to Canada. Because of better protection against violent behavior for women in Canada, Guatemalan immigrant men may feel "inferior" (as Ana puts it) to other men or to their own previous status in Guatemala. Health problems that Guatemalan immigrant men face, particularly alcoholism, are seen as resulting from a "cultural difference" that men face upon migrating to Canada. Conversely, Ana believes that women "take advantage" of an increased sense of opportunity in Canada. These different experiences of men and women illustrate the gender dynamics of migration experience, which in turn have implications for health and well-being.

Carmen emphasizes the importance of men’s work as a cause of ill health. In her view, because men work hard they are driven to drink and suffer overall diminished health status. Indeed, Carmen produces a construction of men/hard work/drink that many of the women shared. Although they believed this was a stereotype of Latino men, they also argued that this construction was true in many cases. But their denial that their own husbands or boyfriends were machistas in this way simultaneously reaffirmed the stigma that is attached to these kinds of behaviors.

Ruth and Laura’s responses are particularly illustrative of the linkages between gendered behaviors and expectations and health. They argue that women’s relative healthiness compared to men is a result of women’s responsibility for looking after children. Women are obligated to move on with their lives because of a culturally or "biologically" determined role towards taking care of domestic matters. Ruth also seems to suggest that since drinking is so strongly linked to being a man in Guatemala, Guatemalan immigrant men in Canada can easily turn to alcohol as an escape from their present situation. Whereas drinking among men may also be seen as a social advantage for men in the diaspora (Laura insisted that men have more opportunities than women to build friendships through sports and drinking), it is also a risk factor for illness. What may be a resource to salir adelante, drinking can also lead to deteriorating social and familial relations.

The second theme that developed through my conversations and interactions with Guatemalan immigrant women was that men are much more reluctant than women to talk about health problems or visit health professionals. This sort of male behavior was linked to cultural practices of machismo. When I asked Laura about the health of Guatemalan immigrant men, she quickly responded:

It hasn’t improved very much because they don’t want to accept it when they are sick and need help. They think they are less manly if they go to visit the doctor. It happens all the time in my family. My husband and my son always avoid visiting the doctor.

"Why machismo?," I queried.

Men have their concepts all wrong, and they think they have to appear strong all the time. If a man shows that he is sick, he is considered a weak person and they don’t want to have that label.

In this narrative, Laura draws an explicit connection between machismo and health. She suggests that not admitting that one is sick¾ and thereby wanting to appear strong¾ is a particular embodiment of being machista. Seeking professional help for health problems, Ana adds, is a gendered practice:

Women are always at the doctors office, and men are never there. Men can be on their death bed and not go. I really don’t know what it is about that; it’s just they’re sort of afraid to admit that there’s something with them. It’s like a weakness to say "I’m not feeling well, I’m gonna get myself checked-out." Up until it’s too late, that’s when they go.

Once again, the notion of "fear" is linked to the health and well-being of Guatemalan immigrant men. Being "fearful" of confronting a health problem is seen as a particularly gendered thing. Going to the doctor, getting a check-up, and taking one’s clothes off in front of a professional are resisted by these men for fear that they will be perceived as weak.

Interestingly, Ana also connects women’s relative health and use of health care services to children. Women are perceived as responsible for children’s well-being, and this partly explains why they may spend more time at the doctor’s than men. However, she also mentions that regardless of whether or not children are involved, it is more acceptable for women to seek professional help for their own individual health problems.

My questions about why men are reluctant to seek help were sometimes met with essentialized statements that "men will be men." For instance, when I asked Carmen why men fear doctors more than women, she replied, "I don’t know why, because they are men!" But after asking her a second time later in the interview, Carmen provided a more thorough explanation:

I don’t know but I still think men feel "macho" all the time and they don’t want to admit when they are sick. Only women do something if they are sick. They go to the doctor and they solve their problems with medication. They seek help. Men don’t want to accept they are sick and need somebody to help them.

This "weakness" (debilidad) that several women refer to as an important obstacle to talking about problems or visiting the doctor may also be gendered in more complex ways. Ana confirmed that being "weak" was a threat to being a man. Our interview was in English and I was curious to know the Spanish equivalent of what she meant by "weak."

The proper word would be "debil." But a slang term would be "jueco," meaning "gay." I have a lot of gay male friends and I would not bring them to my home because I don’t think they would be accepted. So that’s like saying, "Oh, you’re gay, you’re full of it." And don’t tell a man that!

Seeking help for health problems, then, may be associated with feminized or emasculated identities. As several gender theorists have pointed out (Cornwall and Lindisfarne 1994; Gutmann 1996; Lancaster 1992), there is no singular masculinity but only competing sets of masculinities that get produced in different contexts. Hegemonic discourses, Cornwall and Lindisfarne argue, produce subordinate and subversive masculinities (1994:18). In the context of health and health care utilization among Guatemalan immigrant men in Toronto, men who seek help for depression, loneliness, alcoholism or bodily aches and pains may be constructed as juecos and thus enact a subordinate form of masculinity. Juecos, in Ana’s explanation, are "full of it," meaning they are full of complaints and are incapable of keeping these complaints to themselves. This demonstrates Courtenay’s claim that "health related beliefs and behaviors are a means for demonstrating femininities and masculinities" (2000a:1385). Health, like many other aspects of peoples’ lives, is an "enactment of gender" (Courtenay 2000a:1388). The refusal to accept problems with health is a mode for expressing a dominant form of masculinity marked by "keeping the pain."

This chapter has aimed to show the part women play in constructing and talking about this nexus between health and dominant and subordinate masculinities. The next chapter explores the relationship between belonging and health for Guatemalan immigrant men, and proposes that gender may be an important idiom of belonging for immigrant and refugee groups.

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- Abstract/Acknowledgements/Table of Contents -

- Introduction - Chapters 1 | 2 |  3 |  4 |  5 |  6   - Conclusion -

- Appendices - Bibliography -