(Published - 25 April 2019)
What makes you a man? In Xhosa-speaking communities, the transition from boyhood to manhood is marked by a traditional circumcision ritual (called ulwaluko); those who undergo the ritual are generally regarded as ‘men’ – a status that accords respect, social acceptance and belonging to a collective manhood identity (ebudodeni).
But the South African government has been rolling out voluntary male medical circumcision (VMMC) for non-traditional purposes as an instrument to curb new HIV infections. This is an important initiative in a country with a very high number of people infected with HIV/AIDS.
So how do the medical and the traditional intersect? How do Xhosa men perceive voluntary medical male circumcision (MMC)?
According to medical anthropologist Lubabalo Mdedetyana, whose research focuses on voluntary medical male circumcision and its impact on Xhosa notions of manhood that are based on males undergoing the traditional circumcision initiation: “The literature revealed that Xhosa speaking boys who had undergone medical circumcision were stigmatised and viewed as not being ‘real men’ in Xhosa society. Now that MMC is being promoted by the government to fight HIV, my study explored whether such stigmatisations and perceptions of men who had undergone MMC still exist.”
His thesis, Medical male circumcision and Xhosa masculinities: Tradition and transformation, earned him a Master of Arts degree in Medical Anthropology from the University of the Western Cape (the same university where he had previously earned his undergraduate and Honours degrees in Anthropology).
The study investigates Xhosa men’s perceptions of medical male circumcision in Khayelitsha township, Western Cape. Data collection occurred over a six-month period in the Mandela Park community at Michael Mapongwana Community Health Centre, and at a male initiation school.
“My study engaged with ordinary Xhosa-speaking men and sought to understand their views on MMC aimed at reducing the risk of HIV infection. I specifically explore whether the introduction of MMC for HIV-risk reduction has engendered shifts in ideological constructions of masculinity among a selected group of township men.”
The study found that ulwaluko remains a definitive marker of masculine Xhosa identity and is still informed by culture and tradition. Despite VMMC, men who undergo ulwaluko continue to perceive men who choose MMC as ‘the other’ and not as ‘real men’.
“Stigmatisation and negative perceptions of men who had undergone MMC still persist, despite some awareness of VMMC being used as an instrument to curb HIV infections,” Mdedetyana notes.
Xhosa-speaking boys and men who opt for MMC are exposed to various forms of discrimination and stigmatisation by other Xhosa-speaking men and women in their communities. Sometimes, the men are labelled amadoda asesibhedlele (hospital men) or abadlezana (those who have just given birth), and ostracised and prohibited from taking part in many cultural activities.
“To be a man in Khayelitsha, based on the perceptions of the men I interviewed, still means that one has undergone ulwaluko.”
The Measure Of A Man
Currently a researcher at the University of Pretoria, Mdedetyana has extensive experience in the field of public health and ethnographic research, particularly among transgender women, men who have sex with men, people living with HIV, adolescents, transients and homeless people.
He has been a gender and social justice activist at UWC’s Gender Equity Unit, and has worked at the Desmond Tutu TB Centre at Stellenbosch University and at World Waternet.
His work focuses on mental health awareness, stigma and discrimination, identity and structural violence – but male circumcision is a very personal topic.
“I am from Cape Town, born and bred in Khayelitsha, the same area where I conducted the study for my thesis,” says Mdedetyana. “Ethnically, I am Xhosa, and I underwent ulwaluko to be a man. In my community, where I grew up, undergoing ulwaluko is a norm. The expectation is that every boy child at some stage will undertake it.”
Mdedetyana came to anthropology by coincidence.
“My plan was to study psychology. I took anthropology in second semester because I had to have an elective and I soon became intrigued by its method of ethnography, spending time with strange people in order to learn their language and their culture, their worldview.”
Turning those methods on his own culture proved enlightening but Mdedetyana notes that there’s more to the matter of traditional circumcision than simple misogyny or homophobia (as many noted in the recent controversy surrounding Inxeba: The Wound).
“Ulwaluko is something that is associated with the attainment of cultural personhood, based on the idea that one is made to be a man – made to be a person – by the community, not privately by one's self alone,” he explains.
“Those who had undergone VMMC were viewed as having made themselves to be men on their own and as not imbued with cultural personhood based on the collectivist ideas of ubuntu.”
Mdedetyana isn’t ready to give up on this topic yet. “VMMC has the potential to shift constructions of masculinity based on circumcision status. And now that I’ve graduated, my next plan is to register for a PhD, hopefully on the same theme of masculinity and health,” he says. “My dream is to stay in academia, and learn more about how humans and societies work – and apply this knowledge in making a difference.”