CSA&G researcher discusses findings on voluntary medical male circumcision

Posted on May 10, 2019

Lubabalo Mdedetyana has spent a year at the Centre for Sexualities, AIDS and Gender at the University of Pretoria. He tells Primarashni Gower about his work there and his research findings on voluntary medical male circumcision.

PG: When did you join the centre?

LM: I joined the centre last year January. 

PG:What do you do at the centre?

LM: I am employed as a researcher, and I contribute to publications and curriculum development. I also train and lead a research team comprised of student volunteers on a project that is examining inclusivity practices in four chosen universities in South Africa. The criteria that the research examines for is: gender, sexual orientation, trans/non-binary and dis/ability among student organisations of the four respective universities. The programme aims to build the capacity of our student volunteers in the field of research and as future leaders aligned with the imperatives of the South African democracy and constitution. 

PG: Why did you choose this field?

LM: I saw an opportunity to make a difference in contributing to the South Africa of our dreams, one in which everyone is equal and free from stigma, prejudice and discrimination. Many reports show that while South Africa has a liberal democracy that protects the rights of sexual minority groups, there is still widespread hatred and discrimination against people in the lesbian, gay, bisexual, transexual and intersex (LGBTI) community. Reports about corrective rape also abound. Gay men are also more likely to suffer from discrimination when they visit clinics.

Stigma also prevents many from seeking health care, which ­– this barrier to health can entrench the stereotype that gay men are more prone to disease. If they can’t go to the clinic to access condoms or to test for HIV, it means they can’t protect themselves and their loved ones from the risk of being infected. Women are also the victims of patriarchy in our society. They tend to be viewed as inferior to men. The media is replete with accounts of women who have been murdered by men.  

Lubabalo Mdedetyana from the Centre for Sexualities, AIDS and Gender

PG: You recently completed a Master’s thesis on circumcision and HIV. Tell us about this

LM: The research study investigated Xhosa men’s perceptions of voluntary medical male circumcision (VMMC) in Khayelitsha, a township. It explored whether the introduction of VMMC as a state HIV-prevention strategy had engendered shifts in constructions of masculinity and negative perceptions of men who had undergone VMMC. 

Men between 20 and 65 were interviewed about their knowledge, motivations, experiences and understandings of current peer perceptions of those who have undertaken VMMC. I interviewed 14 men who were members of the community, five men at the local clinic and eight from the traditional circumcision initiation school. Male community members were interviewed to gain insight into the local dynamics of the community regarding who is considered to be a “real” man. Initiates were also interviewed. All 14 male community members who were participants were Xhosa-speaking men who had been traditionally circumcised. They represented a wide range and differing periods of time when they had undergone initiation. 

PG: What were the findings?

LM: The main findings were that traditional circumcision (ulwaluko) remains a definitive marker of masculine Xhosa identity and is still informed by culture and tradition. Men who undergo ulwaluko continue to perceive those who choose VMMC as “the other” and not as “real men”.

Because ulwaluko is a deeply entrenched practice, very few men consider VMMC to be a viable option. Those who do consider it an option, think of the stigma and discrimination that is going to be attached to them. It’s not only their peers who will discriminate against them, but the entire community, including some immediate and extended family members. They will not be full citizens of their communities, and will be denied participation in cultural spaces. They will be regarded as boys all their lives even though they have been circumcised.

They receive derogatory infantilising labels from peers. Even those younger than them who have undergone ulwaluko may discriminate against them and are given more power in their community than them. They are considered to be political sell-outs to white people, as turncoats who are working with white people to obliterate African culture. Undergoing VMMC is also considered as cheating and taking shortcuts, and may subject men who undertake it to physical assaults. All of these are factors that deter males from choosing VMMC.

PG: What do the findings mean?

LM: The findings provide some light on why there has been a low uptake of VMMC in the country despite the promise that it has in averting the chances of an HIV infection. VMMC advocates and intervention practitioners must begin to understand that there is going to be resistance to the uptake of the service because of how deeply entrenched traditional notions of masculinity, based on undergoing ulwaluko, are in some South African communities.

They will need to be sensitive to the perception that VMMC has been introduced to eliminate African culture and traditions, that it is just another Western-inspired instrument to undermine African culture and masculinity. Research reveals that respect for African culture and sensitivity with regards to a sense of a Western cultural hegemony is what can create room for dialogue. I thank the DAAD-NRF scholarship for the funding for the research.

What are your future plans?       

LM: I am working on registering for a PhD to build on the theme of masculinity and health. Hopefully this will make me an expert in the field of gender, masculinity and health. I also hope it will have some positive impact for the country.

- Author Primarashni Gower

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