The concept of "discourse" is very helpful in understanding why men must resist negative stereotypes of their gender imposed by those with a negative mind-set. Discourse is a term that is often used synonymously with "ideology". However, it is much more than this, and is a central concept in trying to make sense of the contested area of understanding gender. One fairly precise definition of discourse is:

Foucault is generally seen as being the theorist who has best articulated the idea of discourse, and he provides many examples to illustrate its nature and power. One example is his discussion on the discourse of "madness" (Foucault, 1967) which indicates how the understanding of madness changed over centuries. A "madman" during the middle ages was perceived as someone blessed by God, or under the influence of Satan. Earlier this century the discourse on madness has come under the control of a medical "lens", so that it was often seen as a biological failing involving either genetics or nerochemicals. This has progressed to a point where we now see "madness" as an interaction between biology, experience and social context. Of primary importance is that these understandings then lead to social attitudes and shape social action – such as practicing exorcisms, burning people, locking them away, or giving them drugs. Of course, discourses vary across cultures as well as time, and even vary within cultures. A comment was made at this conference that seeing visions and hearing voices need not constitute madness in aboriginal cultures, as is also the case in a number of other cultures. Thus, the social actions in response to a person’s "madness" will vary.

Discourses exist in relation to all facets of life – there are discourses around the social enterprise of education, on crime and punishment, and of course, on the nature of masculinities. These discourses are not just "a bunch of words" – they determine our social responses. A discourse does not represent what is "real" - it actually produces what we come to understand as real. It determines what can be said, and even what can be thought. It gives us the words and conceptual frameworks by which we attempt to understand ourselves and our experiences, as well as the world "out there". Thus, the concept of discourse recognises the very real ways in which words, and hence understandings, will shape the social lives of men and boys. Discourse, as a concept, stresses the power of an understanding to shape the creation and sustenance of political decisions, policies, social norms, practices and institutions. Foucault was concerned not with simply the origin of discourses, but their implications - their power effects and the types of knowledge they produce and institutionalize (Ramazanoglu, 1993:19-20). For example, the dominant (or hegemonic) discourse around crime not only provides a framework for explaining why people commit crimes, but also determines whether we execute criminals or attempt to rehabilitate them.

In regard to the question of gender and discourse, we need to identify the discourses around the nature of males in our society, and look for the power effects, or implications, of these discourses – for it is these discourses that will determine the social and political responses to men’s and boys’ health needs.

Various discourses about what constitutes "woman" and "man" have appeared over time. In European cultures, the Victorian era’s dominant discourse on women saw them as weak creatures, subject to control by their emotions and reproductive biology. The power effects of this discourse led to social practices, and even legislation, concerning the appropriate occupations and roles of women, and it limited their opportunities to participate in the public sphere of social life. Men, on the other hand, were in this period seen as unable to provide the nurturing required by children, rather as the disciplinarians and provider’s of their family’s material needs. Thus, the power effects of this gender discourse on men resulted in their being largely excluded from the sphere of private life.

Discourses regarding men and women still differ today. This was exemplified in a presentation by an earlier speaker, who noted that young women smoke to control body weight so as to attain a socially defined "attractive" body shape. It was claimed that young men smoke because they see it as a "manly" thing to do. If we deconstruct this statement, we can see that there is an underlying discourse - women are perceived as being subject to outside influences (to their detriment) - that they lack "agency", the power to initiate actions in their own lives - they are largely victims of external forces. Men, however, are seen as having power to choose, as being agents for their own actions, so that men smoke to create a persona. The result (power effects) of this type of discourse, which is common in many areas of men’s and women’s health, is that we attempt to change environments for women (by reducing the emphasis on thin bodies), but tell men to change themselves (by stopping smoking). We locate women’s health challenges outside of themselves, but the challenges to men’s health we see as arising within the men themselves (or in the abstracted men of "masculinities").

This hegemonic, or dominant, discourse on men is most apparent in (and mostly generated by) mass media. When the word "men" appears in the media, it is often in relation to some negative attribute – men as rapists, sexual harassers & abusers, practitioners of violence, unfeeling (or at least out of touch with feelings), and concerned only with power and control. These media images focus on the aberrant behaviours, and at times even pathologies, of a few men who do damage to others, and are themselves often quite damaged.

Of course some men do practice horrific behaviours such as sexual abuse, but this fact is then used contrary to all the protocols of evidential research to blame this behaviour largely on the gender of the perpetrator. If it were true that gender is the underlying causative factor in sexual abuse, then one would expect that a majority of men must practice this. But I have yet to see any attempt at trying to identify what number of men practice this behaviour. I suspect that were such research not avoided, it would find that an extremely small proportion of the male gender chooses to harm children or women for their own sexual gratification. And if it is a small number, then the causative factor cannot be "masculinity" – it may be a necessary condition in cases of sexual abuse, but it is not a sufficient condition. As such, gender cannot be the causative factor.

From literature on perpetrators, I would suggest that pathology of the individual psyche, arising largely from aberrant experiences, led to these aberrant behaviours. And the same arguments apply to other areas in which men are demonised, such as domestic violence. Media articles and surveys indicate a massive number of female victims of DV, as much as 1 in 4, which is then used to imply that there are a similarly massive number of male perpetrators. The failure to provide evidence of the numbers of perpetrators leaves me with no option but to reject this insulting contention – that it is my gender, my male being, that underlies violence against women and children. Blaming these behaviours primarily on the gender of the perpetrator reinforces the myths and negative discourse of men as monsters, and really does not help to address the problem adequately. Such a negative discourse is not only unhelpful for individual men and boys, but also allows for neglect of their needs as scarce resources are diverted to "perpetrator" programs, under the guise that these programs are somehow for the benefit of men as a whole. I do not wish to see perpetrators or sexual abuse or domestic violence refused treatment – I just do want to ensure that this is clearly seen for what it is - treatment for a psycho-pathology, not as an aspect of gender and health.

There are of course alternative, if somewhat marginal, discourses that see men as admirable and as providing care and support for their families and communities, often at great cost to themselves. These alternative discourses draw attention to what is admirable in men, and provide a sense of direction for young men, and criteria against which we can assess ourselves - our relationships and our behaviour - without the burden of guilt involved in the hegemonic negative discourse. Attention to the positive can encourage young men to feel proud, rather than ashamed, of the accident of birth that provided them with a Y chromosome. As one’s gender is central to identity, positive perceptions of maleness are needed to help young men feel that they are valued, and that they do belong to our society. The hegemonic discourse of the "flawed male" can only lead to the experience of social exclusion for many young men, an experience that is known to lead to disastrous consequences for the well-being of individuals and communities. Perhaps we need to draw attention to the fact that some of the most admirable public figures of this century - Mahatma Ghandi, Nelson Mandela, Xanana Gusmao, Pablo Picasso, Albert Namatjira, Yehudi Menuhin and others - are men. Perhaps we also need to note that 99% of those receiving awards for bravery in civic life in Australia this year (1999) are men, and they were acknowledged for engaging in "risk-taking" behaviours that saved the lives of others.

There is obviously a need to construct a positive discourse on men and the nature of masculinities. And even more importantly, we do need to ensure that this blind alley of social theorising does not prevent efforts to improve the health of men.