... but are they also
the elephant in the room?
Considering outcomes
from poor male
with sexual health
Dr David T Evans
RN BA(Hons) MPhil EdD
Senior lecturer in sexual health
It’s a man’s world ...
males are frequently
treated stereotypically,
as though ‘all men are
the same’, with same
needs, attitudes,
behaviours and
Poster: Greg King, CISH 2011
Evans, D. T. (2004). "The trouble with men is ... Raising the profile of
men's sexual health." Nursing in Practice Journal 2004(17): 36-38.
Poster: Loraine Stapley, CISH 2010
many men fail to
make full use of the
various self-help and
health promotion
initiatives, which could
maximise their health
and well-being, and
prevent the development
of disease
Evans, D. T. and L. Stapley (2010). "Sexual health issues in men - part 1."
Practice Nurse (17 September 2010): 30-34.
many men leave
health problems
until they are too
late; consequently,
the treatment is
either radical or
Poster: Eleonora Assenova, CISH 2010
Roberts, C. and D. T. Evans (2007). Chapter: Male Health.
Nurse Practitioner Manual of Clinical Skills. S. Cross and M. Rimmer.
Edinburgh & London, Elsevier Publications: 253-270.
It’s like searching for the “invisibilised”,
something we all know is there
but not speaking about or addressing effectively
... the “presence of an absence” (Jean Paul Satre)
an apophasis [’apofasiV], “absent presence” (Slavoj Žižek)
conceptualises the result
as “screaming silences”
... the “whole [sic]
at the centre of
(Lee et al. 2008).
sex &
sexual health
& well-being
Genders, sexualities, health and well-being
What makes a man a man?
Males often miss out on ‘usual’ health promotion initiatives
“Contraceptive mentality” (Evans 2005)
Viagra phenomenon (Tiefer 2006)
Unprotected sex and infections
• Epidemiology – what the science says and doesn’t say
• Sexually acquired infections (SAIs) and HIV (
• UNAIDS said “48% of people with HIV are women”
Unprotected sex and “family planning”
• Unplanned / (un)wanted conceptions: role and responsibilities
(or not): abortion / pregnancy / “fathering” a child (French 2009a;
Papworth 2011)
• Expectations & regret at intercourse (French 2009b)
• From the youth to the old man! (Roberts & Evans 2007)
Poster: Steve Malone, CISH 2012 May 2013Accessed on 16.04.13
Poster: Angela Wake, CISH 2010
Poster: Vicky Papworth, CISH 2009
Skolbekken (2008)
Non-medical ‘problems’ become seen as
illnesses, disorders, pathologies and
deviancies, which need to be prevented and /
or treated.
Non-medical ‘problems’ characterise the
discursive shift in the west’s postEnlightenment emphasis onto the scientia
sexualis as opposed to the ars erotica
(Foucault 1984, History of Sexuality volume 1)
The result is an increase in all forms of
surveillance and governmentality (Pryce 2001),
especially around “policing desire” (Watney
1993) and the construction / reconstruction of
the notions of deviance and the
“pathologisation of normality” (Skolbekkken 2008).
If it’s not on,
IT’s not on!
Ambition: Prioritise prevention
Ambition: Prioritise prevention
 Build a sexual health culture that prioritises
prevention and supports behaviour change
 Ensure that people are motivated to practise safer
sex, including using contraception and condoms
Increase availability and uptake of testing to reduce
Increase awareness of sexual health among local
healthcare professionals and relevant non-health
practitioners, particularly those working with vulnerable
groups. p 22
Alcohol &
Rage and
bullying and
Mental health
Poor condom
Low Self
“Women have borne
the symbolic burden of
man’s imperfections, his grounding in
nature. Menstrual blood is the stain, the
birthmark of original sin, the filth
that transcendental religion
must wash from man.”
(Paglia 1990: 11)
“Woman is the primeval
fabricator, the real First Mover.
She turns a gob of refuse
[semen] into a spreading web
of sentient being, floating on the
snakey umbilical by which she
leashes every man”. (Paglia 1990: 12)
So many of the indices
such as mortality and morbidity figures
compare male against female,
when it would be more appropriate
to focus instead on
‘preventable’ versus ‘inevitable’,
and very few poor statistics
for men would actually then come out inevitable.
Evans, D. T. (2004). “The trouble with men is ... Raising the profile of men's sexual health.”
Nursing in Practice Journal 2004(17): 36-38.
The needs of boys and young men
are different to that of girls
and this should be acknowledged.
It is important that issues
such as relationships, consent,
contraception and infections
are considered
from a young man’s perspective.
p. 15
All young people’s sexual-health needs – whatever their sexuality –
are comprehensively met. p. 17
The new duties require a
significant change in policy and
practice and what has been
described as ‘gender
This means fully integrating an awareness of
male and female health needs strategically
and operationally throughout an organisation.
It means moving beyond the assumption that
‘gender’ is limited to occasional awareness
campaigns on sex-specific issues.
The Equality Act requires health
organisations to develop and deliver
effective work to improve men’s
health on a wide-ranging and
systematic basis.
While some organisations have a
good track record in this area, for
many it represents a new area of
activity that will require significant
“top up” degree
in sexual health
ie 120 credits
@ level 6
on top of DipHE
PGCert & Masters
in sexual health
as outlined
in the current
CPD prospectus
Baroness Gould of Potternewton
Honorary doctorate in sexual health (2011)
Beatrice Kungwengwe
General Practice Awards 2011 “runner up”
General Practice Awards 2012 “nominee”
Sue Myers
General Practice Awards 2011 “runner up”
Kay Elmy
UK Sexual Health Awards 2012 – winner
Prof Kathryn Abel, Dr David Evans &
Dr Roxane Agnew-Davies
UK Sexual Health Awards 2012 – “finalists”
Dr Kathy French
First edited book on sexual health
Colin Roberts FRCN
Former honorary lecturer
Well over 2,000 on Sexual Health Skills
Dr David T Evans
Senior lecturer in sexual health
[email protected]
020 8331 8069

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