Elsevier

The Lancet

Volume 385, Issue 9977, 18–24 April 2015, Pages 1580-1589
The Lancet

Series
From work with men and boys to changes of social norms and reduction of inequities in gender relations: a conceptual shift in prevention of violence against women and girls

https://doi.org/10.1016/S0140-6736(14)61683-4Get rights and content

Summary

Violence perpetrated by and against men and boys is a major public health problem. Although individual men's use of violence differs, engagement of all men and boys in action to prevent violence against women and girls is essential. We discuss why this engagement approach is theoretically important and how prevention interventions have developed from treating men simply as perpetrators of violence against women and girls or as allies of women in its prevention, to approaches that seek to transform the relations, social norms, and systems that sustain gender inequality and violence. We review evidence of intervention effectiveness in the reduction of violence or its risk factors, features commonly seen in more effective interventions, and how strong evidence-based interventions can be developed with more robust use of theory. Future interventions should emphasise work with both men and boys and women and girls to change social norms on gender relations, and need to appropriately accommodate the differences between men and women in the design of programmes.

Introduction

The need for work with men in the prevention of violence against women and girls (VAWG) is well accepted among advocates, educators, and policy makers. Over the past 10–15 years, interventions involving men and boys have proliferated around the world. These interventions have been motivated by a desire to address the role of men in violence perpetration, and recognition that masculinity and gender-related social norms are implicated in violence.1, 2, 3 Although not all men are violent, all men and boys have a positive part to play to help stop violence against women.4, 5 Furthermore, these men can benefit personally from more equitable relations with women, although use of this argument to encourage men to become involved is somewhat controversial.6

Violence prevention practice has developed during the past few decades from instrumental approaches that target only women to approaches that seek to transform the relations, norms, and systems that sustain gender inequality and violence.7, 8 Gender norms for men have become central. This change can be seen in the language used by practitioners. Initially, men were rarely mentioned, except possibly as (potential) perpetrators of violence.4 The language of men as partners emerged in the 1990s, with men described as allies of women in the work to end men's violence, or the promotion of gender equity. More recent interventions have sought to change the way men see themselves as men (their gender identities) and consequent gendered practices, including the use of violence, sexual practices, and other behaviour towards women (figure 1).9

Prioritisation of, and resource allocation for, work with men on violence prevention has often been contested, not least by female gender activists concerned about opportunity costs and future male domination of the field of violence against women and girls.10 Although they engage men, some interventions have shied away from naming men (eg, by explicit reference to the need to change men's violence against women5) and making their roles visible in the desired change objectives (ie, to change men's behaviour). Interventions have been very varied, and some have excluded women. The use of role models and stereotypical masculine attributes in violence prevention work has been challenged by those who fear that such interventions might reinforce that which we most seek to change.9 Women's groups have voiced concerns that donors have diverted funding from women's programmes and services to work with men, and this has further marginalised women's voices and experiences.6 This Series paper seeks to situate these debates by addressing the questions of why focus on men's violence, what part gender plays, what works in work with men, and how evidence and gender theory can be used to work more effectively to address social norms on gender relations with men and boys in addition to women and girls.

Key messages

  • Men's use and experience of violence is a major public health problem, and men and boys are necessary participants, along with women and girls, in prevention interventions to reduce perpetration of violence against women and girls.

  • Men's perpetration of violence against women and girls is a constituent element of gender inequality, and men's use and experiences of violence are upheld by commonly held versions of manhood. Violence against women and girls is more common where men themselves encounter high levels of violence.

  • Interventions to address perpetration of violence against women and girls by men vary greatly in terms of target groups, change objectives, and methods. Evidence on interventions solely with boys and men is scarce, and most points to some measured attitudinal changes, but not necessarily change in violence perpetration or social norms.

  • Future work should promote more programmes with women and girls, in addition to boys and men, for effective and sustained gender transformation. This work should strive for several varied change objectives related to violence reduction and the factors most associated with perpetration, have enduring effects, and be based on robust theories of change.

  • Interventions need a coordinated focus on multiple risk factors and ecological levels (eg, individual, peer/family, and community levels). Approaches that centre on community norm change have the potential to change versions of masculinity that promote violence. In so doing, they address power and oppression, and seek to change the mechanisms in society that support them.

Section snippets

The multiplicity of men's use of violence

Perpetration of violence against women and girls by men spans the lifecourse. Children can perpetrate sexual violence, but in the teenage years rape becomes more common such that between a half and three-quarters of men who ever rape first do so as teenagers.11, 12, 13, 14 After marriage or dating, some men use emotional, financial, physical, or sexual violence against a wife or girlfriend, and violence often persists throughout the relationship, although it occurs most commonly at younger ages.

Men, masculinity, and violence

So how are these forms of violence connected? A simple explanation is that a society with a culture related to the use of violence, and social norms that are accepting of violence, in many respects permits a range of forms of violence.19, 20 Although this can be empirically supported, it does not explain why men, rather than women, are the most common perpetrators of moderate and severe violence.21 Nor does it explain the links between ostensibly quite different types of violence, such as

Involvement of boys and men in violence prevention

The range of interventions implemented under the header of work with men and boys is very diverse.2, 9, 37 There have been different types of men or boys targeted, changes desired, settings, scope, and durations of interventions. The category has included, for example, both attendance at a brief lecture or drama, and participation in a 50-h workshop-based intervention such as Stepping Stones.1, 38 Interventions have also varied in the gender theory or politics informing them, especially whether

Lessons from prevention programmes

Evidence of the effectiveness of interventions involving men and boys for the reduction of use of violence, or its risk factors, is poor, since rigorous evaluations are few, their geographical base narrow, and the interventions evaluated have often been weak.1 A comprehensive review1 of interventions with men and boys to prevent sexual violence identified 65 high-quality studies, and a handful have been reported since.47 Of the 65 studies, 85% took place in high-income countries and 90% in

Masculinities and change

So how do we build better interventions with men and boys? Present discourse about evidence-based prevention programming emphasises the need for interventions to have an explicit theory of change, grounded in an empirical understanding of the problem. Interventions to prevent male use of violence need to start by understanding the risk factors for men's perpetration. More than 10 000 men participated in the recent UN study in Asia and the Pacific,14 providing valuable insights into factors

Ways forward

Clear ways forward to enhance violence prevention exist in the form of approaches that involve boys and men in addition to efforts to strengthen women's resilience to violence. As a starting point, this Series paper discussed gender theory to explain that violence against women and girls does not occur in a social vacuum, but arises out of a context of gender inequity and social norms of gender relations that are largely supported by both men and women.22, 75, 81 Thus women and men, and younger

Search strategy and selection criteria

Between Jan 27, 2014, and March 31, 2014, we reviewed evaluations of interventions that involved men and boys in the prevention of violence against women and girls. The interventions included those targeting men and boys and workshop interventions directed at individuals, those directed at men in relationships, bystander interventions, school and dating interventions, perpetrator programmes, social norm change interventions including men, and multicomponent interventions including men and group

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