Home work 6

SHORT REPORT

Constructions of masculinity and femininity and sexual risk negotiation practices among women in urban Ghana

Daniel Y. Fiaveh a *, Chimaraoke O. Izugbara

b , Michael P.K. Okyerefo

a , Fenneke Reysoo

c

and Clara K. Fayorsey a

a Department of Sociology, University of Ghana, Legon, Ghana;

b African Population and Health

Research center, Nairobi, Kenya; c Department of Anthropology and Sociology of Development,

Graduate Institute of International and Development Studies, Geneva, Switzerland

(Received 18 February 2014; accepted 13 November 2014)

Using qualitative data gathered through in-depth interviews with women in Accra, Ghana, this paper explores narratives of masculinity and femininity and sexual risk negotiation practices among women. While women framed ‘proper’ masculinity in terms of stereotypical reproductive norms, they also acknowledged the fluidity and multiplicity of masculinities. Femininity was more uniformly characterised in terms of physical attractiveness and beauty, responsibility and reproduction. These features, especially those related to adherence to morally and socially appropriate sexual norms (e.g., menstrual and bodily hygiene, unplanned pregnancy etc.), influenced women’s approach to sexual negotiation. Work aiming to support women to negotiate sex safely needs to pay attention to their notions of gender and practices of sexual negotiation.

Keywords: masculinity; femininity; sexual risk; sexual negotiation; Ghana

Introduction

Women’s ideas of masculinity and femininity, notions of sexual and reproductive risks

and sexual negotiation practices are poorly understood (Boahen 2003; Oliffe et al. 2013;

Pereira 2003; Scorgie et al. 2011; Tamale 2008; Tenkorang 2012). Yet understanding how

individuals construct gender and sexuality is key to making sense of how they perform in

relation to these issues (Butler 2011; Cornwall and Lindisfarne 2005; Howson 2006).

Based on in-depth interviews with a sample of 20 Ghanaian women aged 22 to 79 years,

this paper explores women’s conceptions of masculinity and femininity, their

understandings of sexual and reproductive health (SRH) risks and their SRH-risk

negotiation strategies. Findings have the potential to inform efforts to address SRH-risk

behaviours among women in Ghana.

Notions of hegemonic masculinity have been contested (see Butler 2011; Connell 2005;

Connell and Messerschmidt 2005; Cornwall and Lindisfarne 2005; Howson 2006; Kimmel

and Aronson 2004; Whitehead 2002). Butler’s (2011) performativity theory and

Whitehead’s (2002) work on the sociology of masculinities show that fluidity and

multiplicity characterise masculinities and femininity. Butler (2011), for example, asserts

that although women often have to comply with appropriate (i.e., culturally sanctioned)

masculine behaviour, women and men interact according to the meanings they give to

gender (see also Howson 2006). In countries in Africa, dominant ideologies of masculinity

q 2014 Taylor & Francis

*Corresponding author. Email: [email protected]

Culture, Health & Sexuality, 2015

Vol. 17, No. 5, 650–662, http://dx.doi.org/10.1080/13691058.2014.989264

(e.g., male sexual dominance) are often viewed as a threat to women’s SRH (see Dako-

Gyeke 2013; Inhorn 2005; McFadden 2003; Scorgie et al. 2011). Men are perceived as

sexually active, while women are seen as passive to sex and less likely to negotiate safe sex 1

compared to men (see Macia, Maharaj, and Gresh 2011). Against this backdrop, therefore,

female sexuality is often misconceived as being a passive response to male sexual needs.

Sexuality is not constructed similarly in all cultures and contexts. In many African

contexts (e.g., among the Ashanti of Ghana, the Muslim Jola of Senegal, the Baganda of

Uganda and the Centocow women of southern KwaZulu-Natal province), for example,

women display extensive sexual negotiation skills and are often sexually expressive

(Dellenborg 2004; Fiaveh 2012; Naab 2010; Oliffe et al. 2013; Pereira 2003; Scorgie et al.

2011; Tamale 2006; Tenkorang 2012). Although socially constructed power relations,

including those that are culturally sanctioned, affect the terms on which women engage in

sexual relationships, research shows that women engage in self-reflecting sexual choices

(Fiaveh 2014; Pereira 2003; Scorgie et al. 2011; Tamale 2008). Hence, sexual agency is an

important element of the way in which women manage dominant masculinities and their

SRH-risk negotiation strategies (Howson 2006; Meyers 2002).

Notions of masculinity and femininity in Ghana

As in some other African societies, many Ghanaian cultures mark coming of age with

elaborate initiation rites. The initiation rites for boys centre on a declaration of their

masculinity through bravery and ‘potency’, 2 while those of girls focus on their roles as

mothers and how to conduct themselves toward their would-be partners (Opoku 1978;

Sarpong 1977). These forms of socialisation, which also carry religious values (i.e.,

Christian, Muslim and traditionalist), seek to regulate the situations that can give rise to

sexual interest and to influence people’s sexual activities and practices (Addai 2000;

Opoku 1978).

Courage and bravery are considered masculine virtues in Ghana. The Akan

expressions, ne bo yɛ duru or ne koko yɛ duru (he’s brave) carry a similar meaning to yɛכ barimaכ (he’s a real man) (Adinkrah 2012). A boy or a man whose lifestyle does not measure up to the prescribed expectations of maleness may be branded as banyin-basia or

kwadwo-basia in Akan, meaning a ‘man-woman’ (Adomako Ampofo and Boateng 2011).

It is also believed that women have less courage, as depicted in a common expression

ɛmmaa suro adeɛ (Akan, females are cowards). A woman who veers away from prescribed feminine attributes into the domain prescribed for men may be branded obaa-

barima, the Akan appellation for ‘male-woman’ (Adomako Ampofo and Boateng 2011).

Although the accepted pattern of Ghanaian life is to marry and have children, the

notion of being a ‘responsible man’ or ‘responsible woman’ lies at the very core of

sexuality in Ghana. The concept of the responsible woman includes displaying good

personal hygiene practices; good housekeeping, including good cooking and training of

children (this is expected of the man as well); hard work, modesty and humility;

motherhood and marital fidelity. It is for this reason that even though Ghanaian society is

largely patriarchal (including the matrilineal Akan), women are questioned by the phrase

‘have you seen what has become of your daughter?’ This is because fathers are expected to

prepare their sons for life and to help their sons in choosing potential female partners

(Miescher 2007), while women are largely responsible for bringing up their daughters.

The rigid categorisation associated with male-female gender that stresses dominant

masculine sexual behaviour has become an increasingly contested space in Ghana

(Adinkrah 2012; Boahen 2003). For example, studies (e.g., Dako-Gyeke 2013; Nnuroh

Culture, Health & Sexuality 651

2006, 98) highlight how some discontented or aggrieved wives may deny their husbands

sex by ‘facing the wall’ during sleep in protest at a husband’s behaviour or

‘unfaithfulness’. Although as part of dominant cultural belief, spouses are not expected

to refuse each other sex, a man is expected to respect his wife’s decision not to have sex,

especially on the grounds of experiencing her menstrual period. Across cultures in Ghana,

it is a taboo for men to have sex with women during their menstrual period because it is

seen as ‘unclean’ to do so (Agyekum 2002). However, it remains unclear whether the

sexual negotiation practices of heterosexual women are related to how they constitute

masculinities and femininities in Ghana.

This paper explores narratives regarding the meanings of masculinity and femininity

from the standpoint of urban women in Ghana, and investigates the link between notions

of gender and practices of sexual risk negotiation. Essentially, the paper asks, how do

urban Ghanaian women construct notions of masculinity and femininity, how do they

understand the SRH risks that they face, and how are women’s constructions of gender

reflected in their SRH-risk negotiation strategies?

Methodology

The study was exploratory in character. The population of interest were Ghanaian women,

15 years and above, who had ever had sex, were residents of Madina and were willing to

participate in the study. This population comprises the dominant age range of people who

report being sexually active in Ghana (GDHS 2008). Within this population, interviewees

were selected based on ethnicity, education, marital status, religion and sexual activity.

Interviewing these sub-groups also brought heterogeneity to the sample and diversity of

beliefs and experiences in matters of sexuality.

Access to participants took place through appointments at their homes and work

places. Purposive and snowball sampling techniques were used, the former because of its

effectiveness in identifying specific interviewees (Bryman 2008). For example, there was

the need to capture the experiences of different demographic groups such as the married

and the unmarried, the employed and the unemployed, as well as variations in ethnicity,

religion and sexual experiences. The interviewer (DF) approached potential interviewees

(such as female artisans at work) with the view of having a general discussion about young

people’s sexual behaviour. This approach was useful because in Ghana, adult women and

men are often willing to share their views on young people’s sexuality, especially in

relation to what they regard as the ‘immoral’ behaviour of the youth. A good approach was

for the interviewer to ask a potential participant to share her views on young people’s

sexual behaviour and then redirect the conversation towards the participant’s own sexual

experiences.

We then employed snowballing to identify other interviewees who were willing to

participate in the study (see Biernacki and Waldorf 1981). This method was appropriate

because the study concerned a sensitive issue, sexual pleasure, for which we required

the knowledge of persons who know those who would be willing to participate. The

interviewer (a man) started each discussion with an oral vignette technique that

problematised men’s control over women’s sexuality. For example:

Please, I am Daniel, an Ewe man, but fluent in Twi, Ga, and Hausa [all these being major languages in Ghana]. I spent my childhood days and youth in Accra New-Town, Nima, Akotes, and Madina-UN. My experience in these suburbs of Accra shows that women really have power, contrary to what some people think of women. To most people, men have total control over their women. I think this is not entirely true. In order to document this and to tell

652 D.Y. Fiaveh et al.

the story of women from their own voices, I am undertaking this study. The study focuses on intimacy among men and women. Please, would you be willing to participate? What do you think?

The stress given to the ability to speak the local languages in the above quote served as a

means to building rapport with, and eliciting confidence and trust from, the interviewees.

It was also a means to helping interviewees feel free to discuss their sexuality in their

native language without any inhibition, especially in the case of those who had difficulty in

expressing themselves in, or understanding, English.

In one instance, an interviewee during the interview introduced her friend who had

been curious (i.e., eavesdropping) about what was going on between the interviewer and

the interviewee. The interview was paused to ensure the confidentiality of the interviewee.

She said, ‘eh! meke faru nan?’ [Hausa: what is happening here]. ‘Meh esa kun beri fera

yendeh kun genni?’ [Hausa: why did you two suddenly stop talking when I arrived?]. The

friend mentioned that ‘eh! menaadaa menua baa no oo, marima nka nokore’ [Twi: make

sure you do not deceive my sister, for you men are liars]. The interviewee then requested

that the interviewer talks with her friend afterwards, ‘mepa wo kyew se ye wie a ene ono

nso nkasa’ [Twi: please when we finish, engage her also]. All interviews were conducted

by the first author and participants were assured of anonymity and confidentiality. The

questions included: what is a man, what is a woman, are women at risk of men’s sexual

behaviour (probing for why)?

Overall, 20 women aged 22 to 79 years participated in the study. The age distribution

shows that more than half of participants were under the age of 40, reflecting the

comparatively youthful age structure of Accra. With the exception of two participants who

were pursuing full-time education, the rest were working. Of the women, 15 were

Christian while 5 were Muslim. Ten were married (Table 1). The Institutional Review

Board of the Noguchi Memorial Institute for Medical Research, University of Ghana,

granted ethical clearance (NMIMR-IRB CPN 048/11-12). Data were collected with

informed consent and the names attributed to informants in this paper are pseudonyms to

protect confidentiality.

Data analysis

Audiotape interviews were transcribed verbatim using expert translators. The transcripts

used pseudonyms, the location of interviewees and date of interview. All records (e.g.,

interviews and transcripts) were treated confidentially.

The transcripts were read three times. The first two readings were to understand the

transcript and highlight emerging codes and themes. Notes were recorded for further use.

In the final reading, a coding frame was made. The coding was carried out using a

constructivist paradigm and focused on interviewees’ lived experiences. The themes

developed included women’s constructions of masculinity, women’s constructions of

femininity and their sexual-risk negotiation strategies. Interview segments with similar

meanings were coded under one theme to avoid the repetition of themes.

The first author contacted all the interviewees three months after the interview for a

meeting or telephone conversation. In this conversation, he presented some preliminary

findings and interpretations of their narratives and sought confirmation and feedback

regarding the interpretation of the data. While it was not possible to contact all

interviewees (due to their work and busy schedules, relocation, travel, communication

problems and other reasons), feedback from those contacted (six women) is presented as

part of the discussion.

Culture, Health & Sexuality 653

T a b le

1 .

D e m o g ra p h ic

c h a ra c te ri st ic s o f in te rv ie w e e s.

R e sp o n d e n ts #

P se u d o n y m

A g e

M a ri ta l st a tu s

D u ra ti o n o f re la ti o n sh ip

E d u c a ti o n

R e li g io n

O c c u p a ti o n

R 1

S u m a y a

3 6

N e v e r m a rr ie d

1 y e a r

P ri m a ry

M u sl im

S e a m st re ss

R 2

A sa n te w a a

4 3

M a rr ie d

8 y e a rs

M id d le

sc h o o l

C h ri st ia n

T ra d e r

R 3

M e m u n a

3 5

R e m a rr ie d

2 y e a rs

S S S /S H S

M u sl im

T ra d e r

R 4

N a a

3 7

R e m a rr ie d

3 m o n th s

T e rt ia ry

C h ri st ia n

L e c tu re r

R 5

S it so fe

3 1

M a rr ie d

2 y e a rs

T e rt ia ry

C h ri st ia n

T e a c h e r

R 6

D z id z o r

3 8

N e v e r m a rr ie d

2 y e a rs

V o c a ti o n a l

C h ri st ia n

S o c ia l w o rk e r

R 7

A id a

3 7

M a rr ie d

1 1 y e a rs

T e rt ia ry

C h ri st ia n

L e c tu re r

R 8

H a ji a

5 3

M a rr ie d

2 6 y e a rs

N e v e r a tt e n d e d

M u sl im

T ra d e r

R 9

Z u

2 6

N e v e r m a rr ie d

6 m o n th s

T e rt ia ry

M u sl im

S tu d e n t

R 1 0

A k o su a

3 2

N e v e r m a rr ie d

N o t in

re la ti o n sh ip

T e rt ia ry

C h ri st ia n

B u si n e ss

w o m a n

R 1 1

A n ti N u rs e

5 6

D iv o rc e d

1 0 y e a rs

o f d iv o rc e

P o st -s e c o n d a ry

C h ri st ia n

N u rs e

R 1 2

K o sh ie

3 6

M a rr ie d

1 y e a r

P o st -s e c o n d a ry

C h ri st ia n

A d m in is tr a ti o n a ss is ta n t

R 1 3

G y a m fu a

2 5

N e v e r m a rr ie d

6 y e a rs

T e rt ia ry

C h ri st ia n

S tu d e n t

R 1 4

A k o fa

3 0

N e v e r m a rr ie d

2 y e a rs

P ri m a ry

C h ri st ia n

H e a lt h a ss is ta n t

R 1 5

A d u ro

w o ra

7 9

W id o w

2 5 y e a rs

N e v e r a tt e n d e d

N o t re li g io u s

M e d ic in e se ll e r

R 1 6

O y e -M

a n sa

2 2

M a rr ie d

4 m o n th s

T e rt ia ry

C h ri st ia n

S tu d e n t

R 1 7

M a a m e

3 0

N e v e r m a rr ie d

5 m o n th s

T e rt ia ry

C h ri st ia n

T e a c h in g a ss is ta n t

R 1 8

A d w o a

3 3

M a rr ie d

1 0 y e a rs

U n d e rg ra d

C h ri st ia n

T e a c h e r

R 1 9

Ju n

3 1

N e v e r m a rr ie d

N o t in

st a b le

re la ti o n sh ip

T e rt ia ry

C h ri st ia n

N u rs e

R 2 0

A b su

4 2

M a rr ie d

8 y e a rs

T e rt ia ry

C h ri st ia n

A d m in is tr a to r

N o te : S S S /S H S , S e n io r S e c o n d a ry

S c h o o l/ S e n io r H ig h S c h o o l.

654 D.Y. Fiaveh et al.

Interview extracts included in this paper were direct translations of the interviewees in

their local languages and oral (‘broken’) English. This is to retain the faithfulness of the

transcripts and to project the interviewees’ own voices.

Limitations

Considering the non-random nature of the selection of participants, caution should be

taken in generalising the findings of this study. The interviews were conducted by a male

researcher, who was discussing culturally sensitive topics such as heterosexual sex,

homosexual sex and sexual pleasure with female respondents. There is a possibility that

some respondents were inhibited in their answers or simply provided what were perceived

to be culturally acceptable answers.

Results

Women’s notions of masculinity

Women defined men in terms of one of three main features: physical characteristics (e.g.,

having a penis), reproduction (e.g., ability to get a woman pregnant) and responsibility

(e.g., care for one’s partner). These three components do not conflict but reinforce one

another and the inability to acquire the full complement does not mean a man is

incomplete or has failed in his masculinity.

Physically, having a male identity includes being ‘created’ as a man and having a penis

(i.e., kɔteɛ in Twi, aʋa in Ewe, gbɛɛ in Ga and bura in Hausa). The possession of a penis forms an important part of constructions of masculinity among women because all claimed

to have engaged in penis-in-vagina sex (with their male counterparts). When women

identified men as having a penis, the main focus was on men’s phallic competence (i.e., the

ability to have and sustain an erection, the capacity to perform during sex and satisfy a

woman and the ability for the penis to ‘impregnate’ a woman [to bear a child]).

With respect to reproduction, the women sampled were of the view that, ‘Oh, if a man

is unable to bear a child, he is still a man!’ Rather, the main emphasis for the women was

on responsibility (i.e., the ability of a man to provide for himself, his partner [if any] and

dependents). These characteristics did not vary by age, marital status, religion or even the

socioeconomic class of the women interviewed.

Women interviewed indicated that even men who were unable to provide for their

family still earned some acknowledgement for their social position. In this regard,

responsibility transcended the financial to include caring, respect for a woman, fidelity/

faithfulness and giving spiritual, emotional and psychological support through respect for

women and being ‘a nice man’:

Here in Zongo, anytime you find a man and his girlfriend or wife quarrelling, the woman often say that ‘you koraa are you a man [are you a man at all]?’ I think for me I will only ask that question if you are not playing your role as a responsible person, not in bed [sexual intercourse]. For me, bed is only two or five percent. Financial, emotional, and religious luxury, if you are doing that as a man, respect for a woman, and control [controlling one’s sexual desires], it does not matter what you do in sex. If you are very active in bed and you don’t look after your children, what makes you a man? And that’s what our forefathers were using because they had lots of children . . . [pause] then, eeei, you are a man. You have 10 children, you are a man, meanwhile you cannot look after them and lack sexual control. Before you say jack, he has infected you with something. (Sitsofe, 31 years, married)

Women also stressed men’s sexual behaviour. Participants were of the view that men were

easily moved to have sex. The manner in which a man makes sexual overtures offers an

Culture, Health & Sexuality 655

indication of whether he has control over his sexual behaviour, which was an important

element in some women’s understanding of a ‘proper’ man. Women also mentioned the

importance of good appearance in terms of dressing neatly, being clean shaven and

‘smelling good’. The presence or absence of body odour provided a good indication of

how ‘responsible’ a man is or not, or is likely/unlikely to be. Women stated that a man’s

‘appearance’ is indicative of how he organises himself and his household in general.

Constructions of femaleness

The women interviewed distinguished between what they referred to as a ‘contemporary’

woman (ɛnɛ maa and mmabawaa aba, literally meaning ‘today’s women’) and a ‘traditional’ woman (yɛn brɛ so,3 meaning during our time). A contemporary woman was perceived to have a complex identity, transcending the narrowness of certain cultural

values (e.g., the need to bear a child) with which women are often identified. The identities

of women were categorised in terms of four major themes: 4 physical characteristics,

responsibility, reproduction and independence.

The main physical features mentioned were biological (i.e., vagina and breasts) and

social (i.e., ‘beauty’, in terms of a woman’s face, her hair, and her shape). One of the

women, for example, identified herself as me gyinaso [Twi: I have good physical

attractiveness]. Six women indicated the vagina was an important aspect of their

femininity. They maintained that without a vagina to attract men, you are not a woman.

Real women need a vagina to complement men’s penis. They frequently referred to the

vagina euphemistically in various ways such as Akosua Kumaa or Akosua Mansa [Twi:

proper names for women] and buemi [Ga: a hole]. The vagina is, however, known as ɛtwɛ in Twi, toto or sormi in Ga, edo or kolo in Ewe and duri in Hausa. To all the women

interviewed, being a woman is a physiological act of God.

With respect to reproduction and the construction of femininity, women were of the

view that ‘if you don’t bear a child’, ‘if you are not married’ and ‘if you are not even in a

relationship’, a woman is still a woman. The only stereotypical characteristic women

adopted from the ‘traditional’ construction was the concept of ‘motherliness’

(i.e., showing concern for those in need, especially children), something they considered

as a given. However, reproduction and their own ability to bear children was not a concept

the women often used to identify themselves, just as they had not done in the case of men:

One of the things that defines me as a woman is my role as a mother and someone who can bear children. Even before I had my first child, I was ‘mothering’ [caring for] my siblings. I think I have some special gifting in mothering people and taking care of myself, my home and playing that role. Even though I say that defines you doesn’t mean that if you don’t have a child you can’t be a woman. You can mother other people and be such a blessing. Nieces and nephews will come and tell me or ask me what they won’t ask their parents. So it is that nurturing ability. (Naa, 37 years, remarried)

Although some women said that they were happy to bear a child, there was no narrative

whereby a woman with an inability to bear a child signified an incomplete femininity.

Another key aspect of femininity mentioned in the study was independence. The

reason why this was important for women was because they linked it to several facets

(such as financial autonomy, intelligence, smartness) of their lives that enable them to

have control over their sexuality, including the ability to negotiate sexual options. Ideas

about being intelligent and smart were not only assigned to women who had received

formal education, but to all women who were conscious of their wellbeing, although

culturally these attributes are traditionally perceived as male attributes:

656 D.Y. Fiaveh et al.

It’s a lot of things [pause]. Okay so physiologically you have been born or created a woman, that is one. You don’t necessarily need to have a man in your life to feel fulfilled as a woman. It’s a combination of beauty and brains. And when I talk of brains, am not talking about just academic brains, because there are some women who are not good in school but whatever business you are doing, you should be smart. If it a business, if it’s being a mother, whatever role you are playing, you should be smart in that area not just academic prowess. You should be able to take care of your children and your home. It’s everything. (Sitsofe, 31 years, married)

Femininity was also constructed in terms of responsibility. Responsibility was constructed

around the ability to care for oneself (such as being able to afford clothing and cosmetics)

and provide for one’s children and parents. These attributes did not differ from the way in

which the women also perceived men. However, for women, responsibility goes in tandem

with the notion of independence because the former propels the latter. For instance, the

women were of the view that once a woman is responsible for her own ‘life’ (such as the

ability to meet one’s material needs), then she has independence and is less dependent on a

man whether married or not, Muslim or Christian, younger or older, educated or not.

Sumaya, aged 36 years, had this to say:

What shows I’m a woman? I can provide for myself, I do provide for my parents, am working and at periods when my father and mother don’t have I help my younger siblings. I personally feel ok, what I want is what I do, is not like I wait for someone to provide for me before I eat. I feel am ok and a woman. (unmarried)

Other participants drew on more stereotypical social values. For some, a responsible

woman was perceived as someone who looked after her personal hygiene, engaged in

household duties (such as cooking and keeping her surroundings clean), cared for children

and provided spiritual support (in the context where a woman was a member of a religious

group, with several informants citing Ephesians 5:24 5 or the Hadith

6 to support their

claims). Others perceived a responsible woman as someone who could ‘handle a man’

(through concern for her own health in dealing with men’s sexual advances) and who had a

‘good’ character.

Risk-negotiation strategies

Women had multifaceted understandings of sexual risks. These included biological risks

(i.e., getting infected with an sexually transmitted infection, not being able to get pregnant)

as well as social and moral hazards (e.g., getting pregnant fortuitously, losing one’s respect

as a woman, appearing easy and cheap, being seen as too exposed or too traditional, anal

sex, poor menstrual hygiene etc.).

For women, dealing with sexual risks involved having a good knowledge of men’s

sexuality and what they want, knowing one’s self, knowing how to keep clean during

menstrual periods, being able to satisfy men, not letting men use you and being able to

manipulate men. For example, physical features such as ‘beauty’ were important factors

for some men sexually. Some women therefore used their beauty to entice men and

negotiate. In particular, younger and unmarried women used expressions such as ‘am not a

cheap woman’ to indicate that not ‘any man’ could have sexual access to them. Instead,

they were only interested in men with certain physical characteristics (such as ‘good

looking’ men). Younger women in particular said they would not date or marry a man who

exhibited the characteristics that they identified as implying ‘irresponsibility’, because

‘they are not [real] men’.

For other women, especially younger ones and those who were never married,

unplanned pregnancy constitutes a sexual risk because men may not accept the

Culture, Health & Sexuality 657

responsibility of the child. All the unmarried women indicated that for most men, sex was

primarily about pleasure and nothing more. That said, a degree of sexual agency was

expressed in women’s language through expressions such as ‘are you ready to marry me?’,

‘are you ready to be a father?’, ‘please use it [condom] since we are not ready’ as dominant

narratives used to negotiate safe sex.

Dzidzor, 38 years old, had this to say:

If I had not insisted or managed to convince the guy to use condom that would have been a big problem. It would have been a big problem, I would have had unwanted baby because am not working now. They [men] don’t care too. As for them is all about the enjoyment. So it’s good for you to decide when and how you have to have sex and where, it’s very important. I only asked him one question, i.e., are you ready [to be a father]? And he is always fumbling. That tells me straight away that this guy is not ready, so we need to play it safe. (unmarried)

Sexual risk is also related to irresponsible practices such as anal sex and poor menstrual

hygiene. Women were of the view that sex should occur by means of a vagina and a penis,

and that sex should be hygienic. All stressed the unique differences in the reproductive sex

organs for men (the penis) and women (the vagina), and the positioning of such sex organs

(i.e., located in between the thighs for both sexes) as ideal for sex. One interviewee had

this to say:

It’s not good. But men too have anus. So you don’t you know this? [questions the interviewer] How can you allow someone to insert that thing [penis] at your back [anus]? Can you give birth by having sex through your anus? I was told that it can cause the place [anus] to weaken and when you go to toilet, the thing [faecal matter] just drops ‘toom’ like that [an onomatopoeic expression for the easy drop of faecal matter from the anus into the toilet]. This can even affect your womb also. Because you are married, so you should allow a man to just ‘use’ you like that [sexually exploit you]? As for men, if you allow them, they will do what they want with you. You the woman have to be strong [smart and assertive on your rights]. Me if you [partner] try that thing with me, I will run away and leave you (Akofa, 30).

Context-specific meanings of ‘cleanliness’ in the form of good menstrual hygiene were

important in women’s conceptions of sexual risk. Except for two women, the remainder

considered sex during menstrual period to be ‘indecent’ and ‘unhealthy’. The women used

expressions such as wa bu ne nsa (Twi: she has broken her arm), and e efee yei anii

(Ga: she is behaving like a woman) to get responsible men to show care because the

menstrual period can be likened to a woman in ill health. Women believed that ‘proper’

men like decent sex and will not have sex with woman who is menstruating. Those with a

strong commitment to religious values claimed that their religion forbade sex during

menstruation (Twi: yen sum no mpena saa) and that a good and a ‘God fearing’ man would

exercise sexual restraint. In the words of an interviewee:

You see, men think they are smart but we women are smarter. I just tell him I’m in my menses since he knows I will not have sex when I am in red [menstruation]. It’s not healthy. A good Christian won’t even do that. (Sitsofe, 31 years, married).

Even for women who claimed that they did have sex during their menstrual period, their

narratives of sexual risk were still related to responsible behaviour in the form of ‘good’

hygiene-related vaginal practices. Zu was pragmatic about it:

We are often careful, especially when am ovulating because I don’t want to get pregnant. You know men, when you get pregnant then they start their thing, blaming you. ‘How come’, as if you had sex alone. But in my menses, I wash down and it’s ok [no smell and so I can have sex in menstrual period] and am safe. . . . A woman needs to ensure that her vagina is tidy. (26 years, never married)

658 D.Y. Fiaveh et al.

Finally, women claimed that ‘good’ (proper) men like reputation (i.e., to be seen as

responsible men) and hate embarrassment. So women threatened to scream and shout out

if men wanted to force them to have sex when they were at risk of getting pregnant, or

when they suspected the man had an infection, or or when the man wanted to rape them or

engage in ‘improper’ sexual practices:

He has been forcing me, let’s try this lets try that. One day . . . I don’t even know what happened but in changing the [sex] position he tried that stupid thing. I screamed and he stopped since he didn’t want the people around [neighbours] to know what was going on. Some men are very stubborn but it’s because they haven’t met someone like me. If a man respects you [a woman] he won’t do that [coerce a woman into having sex]. (Akosua, 32 years, never married)

Discussion

The paper has examined the construction of masculine and feminine identities linked to

the modern-day sexuality of women in urban Ghana, and highlights women’s sexual

negotiation practices. The women sampled defined women and men in a variety of ways.

Their constructions of ‘proper’ masculinity ranged from stereotypical reproductive norms

to fluidity and multiplicity in masculinities. For example, in the context where a woman

was a member of a religious group, the moral code of such group influenced how she

managed and defined gender identities (see Addai 2000; McFadden 2003; Oliffe et al.

2013; Pereira 2003; Tenkorang 2012).

Differences in the construction of gender identities (such as being a responsible

woman or an independent woman), and the meanings attached to these, determined

individual women’s sexual risk negotiations. The notion of being a ‘responsible man’ and

a ‘responsible woman’ goes to the very core of women’s sexuality in Ghana. Aspects of

this responsibility include care for children (expected of both men and women), hard work,

‘motherhood’, ‘fatherhood’ and sexual fidelity. Responsibilities are also strongly

gendered. For femininity, responsibility overlaps with the notion of independence, which

emanates from the notion of being smart, and the ability to ‘handle a man’s’ sexual desires,

while drawing on agentic strategies such as threatening to shout when negotiating the risk

of unwanted sexual overtures and practices.

From the narratives provided by women, a man’s decision to discontinue an unwanted

sexual act was also influenced by the need to protect his reputation. In most cultures in

Ghana, men who coerce women into sex lose respect, becoming a focus of ridicule.

Narratives depicting such disapproval include berma enyɛ saa (a man should not behave in that manner) and yen forso obaa oo, obaa pɛ woa na opɛ wo (you don’t force a woman, if a woman loves you then she does it). These narratives in themselves ‘strip’ such men of their

masculinity or, as Cornwall and Lindisfarne (2005) put it, disclocate it. A man who refuses

sexual overtures from a woman is often regarded as a ‘weak’ man, and described in local

parlance as an otoolege or kotobonku (Ga), as a banyin-basia (Twi) or, as Nnuroh (2006)

bluntly put it, a useless man. While women’s agency in sex may sometimes be triggered by

‘decisive protest femininities’ (see Howson 2006), that of men remains influenced by more

hegemonic forms of masculinity.

To conclude, women’s understanding of the SRH risks that they face are closely linked

to notions of gender. Although the women’s agency was expressed within the confines of

masculinist ideology (see Connell 2005; Whitehead 2002), women in this study reported

negotiating sex according to self-reflecting sexual choices. Nevertheless, deconstruction

of the rigid categorisation associated with male-female gender identities that stresses

Culture, Health & Sexuality 659

masculinity ideals in Ghana remains both urgent and critical (Adinkrah 2012; Adomako

Ampofo and Boateng 2011; Boahen 2003; Fiaveh 2012).

Acknowledgements

An earlier version of this paper was presented at the Population Association of America Annual Meeting, Boston, MA, May 1–3, 2014. We acknowledge the input of Nathalie Bajos, Jenny A. Higgins and participants for useful comments on the earlier draft.

Funding

This study was supported by the CODESRIA-Small Grants Programme for Thesis Writing [Ref: SGRT.11/T11] and a Ghana Studies Association Research Grant.

Notes

1. The capability and the freedom of all persons to have a satisfying sexual life and to decide if, when and how often to do so, including all matters relating to the reproductive system at all stages of life (see WHO, 2006).

2. Ability of a man to satisfy a woman sexually. 3. The equivalent of these Twi expressions exist in other Ghanaian languages too, and those

interviewed were not Akan-speaking only. 4. The women interviewed were given the freedom to express these identities. 5. ‘But as the church submits to Christ, so also wives should submit to their husbands in

everything’. 6. The collected traditions, teachings and stories of the prophet Muhammad, accepted as a source

of Islamic doctrine and law, second only to the Koran.

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Résumé

En s’appuyant sur les données obtenues lors d’entretiens en profondeur conduits avec des femmes dans la ville d’Accra, au Ghana, cet article explore les récits évoquant la masculinité et la féminité, ainsi que les pratiques de négociation du risque sexuel chez les femmes. Alors que les femmes ont défini la « véritable » masculinité avec un vocabulaire reflétant des normes reproductives stéréotypées, elles ont reconnu que les masculinités étaient fluides et multiples. La féminité a été caractérisée de manière plus uniforme, avec un vocabulaire renvoyant à l’attrait physique, la beauté,

Culture, Health & Sexuality 661

la responsabilité et la reproduction. L’enquête a révélé que ces caractéristiques, en particulier celles qui étaient en rapport avec l’adhésion à des normes sexuelles appropriées – du point de vue moral et social (par ex. l’hygiène menstruelle et corporelle, les grossesses non planifiées, etc.) – avaient une influence sur l’approche employée par les femmes dans la négociation sexuelle. Les programmes visant à renforcer la capacité des femmes de négocier leurs rapports sexuels en toute sécurité doivent prendre en compte leurs notions de genre et leur pratique de la négociation sexuelle.

Resumen

Mediante el uso de información cualitativa recabada a través de entrevistas a profundidad aplicadas a mujeres de Accra, Ghana, el presente artı́culo examina las narrativas de masculinidad y de feminidad, ası́ como las prácticas de negociación empleadas en los casos que las mujeres emprenden relaciones sexuales arriesgadas. Si bien las mujeres caracterizaron la masculinidad “correcta” en términos de normas reproductivas estereotipadas, también reconocieron la existencia de masculinidades fluidas y múltiples. A su vez, la feminidad fue caracterizada en general en términos de atractivo fı́sico y belleza, de responsabilidad y de reproducción. Estas caracterı́sticas, y en especial las vinculadas al acatamiento de normas sexuales apropiadas moral y socialmente (por ejemplo, la higiene menstrual y corporal, el embarazo imprevisto, etc.), influyen en el enfoque que utilizan las mujeres a la hora de la negociación sexual. Los programas orientados a apoyar a las mujeres a fin de que negocien relaciones sexuales seguras deben centrar la atención en sus ideas de género y en sus prácticas actuales de negociación sexual.

662 D.Y. Fiaveh et al.

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