665990

research-article2016
SAP0010.1177/0081246316665990South African Journal of PsychologyBantjes et al.

South African Journal of Psychology 2017, Vol. 47(2) 233­–245 © The Author(s) 2016
Reprints and permissions: sagepub.co.uk/journalsPermissions.nav
DOI: 10.1177/0081246316665990 journals.sagepub.com/home/sap

Article
Young men in post-apartheid South
Africa talk about masculinity and
suicide prevention

Jason Bantjes, Ashraf Kagee and Birte Meissner

Abstract
We explored the experiences of a racially mixed group of young men in post-apartheid South
Africa to investigate how they conceptualised suicide and document their suggestions for suicide
prevention. Data were collected via in-depth semi-structured interviews and analysed using
thematic content analysis. Findings suggest that in spite of socio-political transformation, young
men in South Africa may not feel liberated to deviate from traditional gender norms. Participants
described restrictive heteronormative gender roles that are akin to hegemonic masculinity and
that create a rigid gender regime that prevents authentic relating, disconnects young men from
each other, and makes it difficult to receive emotional support. Participants attributed suicidal
behaviour to feelings of disconnectedness, thwarted belonging, pressure to conform to the
gender regime, and feelings of shame when unable to achieve masculine ideals. They suggested
that suicide prevention should be aimed at fostering connectedness, relationship building, and
disrupting the gender regime. Furthermore, they suggested that in cyberspace, the gender regime
was less rigid and stated that they felt more liberated online to express distress and access
support, which has implications for suicide prevention interventions.

Keywords
Gender regime, masculinity, men, suicide, suicide prevention, thwarted belonging

In the last 20 years following the advent of democracy in South Africa (SA), a human rights dis-
course has become dominant in the political and cultural zeitgeist of the country. SA’s constitution
has enshrined gender equality and non-racism as fundamental features of post-apartheid society.
Yet, among men, there are high rates of human immunodeficiency virus (HIV) infection, interper-
sonal violence, risk-taking behaviours, and substance abuse (Seedat, Van Niekerk, Jewkes, Suffla,

Department of Psychology, Stellenbosch University, South Africa

Corresponding author:
Jason Bantjes, Department of Psychology, Stellenbosch University, Private Bag X1, Matieland 7602, Stellenbosch,
South Africa.
Email: jbantjes@sun.ac.za
234 South African Journal of Psychology 47(2)

& Ratele, 2009). Men account for 80% of completed suicides in SA (Bantjes & Kagee, 2013) and
may constitute as many as 40% of patients seeking treatment for self-harm in urban hospitals. It
has been suggested that hegemonic models of masculinity in SA account for the high rates of sex-
ual and physical violence and homicide, and the pattern of injury-related morbidity and mortality
(Coovadia, Jewkes, Barron, Sanders, & McIntyre, 2009; Seedat et al., 2009). Less attention has
been paid to possible links between dominant ideals of masculinity and self-directed violence, such
as deliberate self-harm and suicide. In this study, we explored the lived experience of being a
young man in contemporary SA and the ways in which a racially mixed group of young men under-
stood suicidal behaviour. We adopted a data-driven inductive approach by making theoretical sense
of our findings after data analysis. We present our findings and discuss the implications by drawing
on notions of hegemonic masculinity (Connell, 2000) and the concept of a gender regime, that is,
the institutionalised gender practices, patterns of communication, role expectations and allocation
of resources along gender lines within a society (Connell, 1996). Our participants’ perceptions of
links between suicidal behaviour and masculine gender roles are also discussed within the context
of Durkheim’s sociological theory of suicide (Durkheim, 1897, 1951) and the concept of thwarted
belonging (Joiner, 2005). We conclude by considering the possible implications of these ideas for
suicide prevention in SA.

Masculinity in SA society
SA’s history of slavery, war, violence, and apartheid has shaped the dominant forms of masculinity
in the country (Coovadia et al., 2009; Delius & Glaser, 2002; Mager, 1999; Morrell, 2001).
Hegemonic masculinities have historically been racially defined and have tended to valorise char-
acteristics such as physical strength, courage, and an acceptance of hierarchical authority
(Breckenridge, 1998; Morrell, 1998). In 19th century Boer republics, for example, it was common-
place for White Afrikaner boys from a young age to be organised into Boer Commandos; militaris-
tic social structures which encouraged performances of brute strength, courage, and physical
domination through violence (Swart, 1998). Similarly, until recently in Natal, boys’ schools
employed compulsory participation in sports like rugby to inculcate values such as physical prow-
ess and bravery as well as ideas of racial superiority, gender hierarchy, and class chauvinism
(Morrell, 2001). In the mining sector, the high concentration of male miners living together under
harsh conditions fashioned explicitly racial masculinities characterised by interpersonal violence,
risk-taking, and the stoic endurance of physical pain (Breckenridge, 1998). In indigenous Black
cultures, socialisation of boys entailed training in fighting with traditional weapons which was a
practice deliberately employed to instil discipline, courage, and fighting skills (Morrell, 1998).
Under apartheid, conscription of White men into the South African Defence Force also contributed
to creating models of masculinity which are congruent with military ideas of control, power, domi-
nation, and violence (Conway, 2007).
SA’s history has created dominant forms of masculinity predicated on heroic displays of tough-
ness, fearless defence of honour, physical domination, risk-taking, the use of strategy, and male
camaraderie (Morrell, 1998). Exaggerated performances of male masculinity are, for example,
evident in contemporary urban youth gang culture in SA (Delius & Glaser, 2002). There are of
course exceptions to this with evidence, for example, suggesting that among isiXhosa speakers,
adult men are encouraged to use persuasion and law, not violence, to address problems and reassert
themselves (Mayer & Mayer, 1970).
Dominant ideals of masculinity may be implicated in the high incidence of physical and sexual
violence, homicide, and injury-related morbidity and mortality (Coovadia et al., 2009; Seedat
et al., 2009). High rates of death related to road traffic accidents (especially those caused
Bantjes et al. 235

by speeding and drunk driving) have been ascribed to an enactment of the masculine ideals of
toughness and risk-taking (Hearn, 2007; Ratele, 2008). Less attention has been paid to possible
links between masculinity, self-directed violence, and suicide in SA, although one qualitative study
of the narratives of 52 cases of completed suicide concluded that the main precursor for male sui-
cide in SA was the desire to escape from a thwarted dominant masculine position (Niehaus, 2012).

Suicide and self-harm among men in SA

Official rates of completed suicide are estimated to be 13.25:100 000, with suicide accounting for
approximately 9.8% of unnatural deaths and 80% of completed suicides occurring among men
(Bantjes & Kagee, 2013). Men accounted for 31.1% (n = 101, mean age = 26.1 years) of attempted
suicide cases referred to clinical psychologists over a 12-month period in a single hospital (du Toit
et al., 2008). Moosa, Jeenah, Pillay, Vorster, and Liebenberg (2005) reported that 39.5% (n = 17) of
all suicide attempters admitted to Johannesburg General Hospital over a 1-month period were
male. A national survey of 4,351 SA adults suggested that the lifetime prevalence of suicide idea-
tion, plans, and attempts among men was 8%, 3.3%, and 1.8%, respectively (Joe, Stein, Seedat,
Herman, & Williams, 2008). In other countries, gay, bi-sexual, and transgendered individuals are
at increased risk of engaging in suicidal behaviour (King et al., 2008; Skegg, Nada-Raja, Dickson,
Paul, & Williams, 2003).

Theories of suicidal behaviour

There is a long and established history of theorising about suicidal behaviour. As early as 1987,
Emile Durkheim published a sociological perspective on suicide entitled ‘Le Suicide’, in which he
proposed that suicide could be a response to either a lack of social regulation (anomie suicide) or a
lack of social integration (egoistic suicide) (Durkheim, 1897, 1951). In the past 50 years, biomedi-
cal approaches have focused on understanding suicide as a symptom of psychopathology and on
identifying individual risk factors that are associated with suicidal behaviour (Hawton & van
Heeringen, 2009). Contemporary theorists such as Joiner have drawn attention to the role of sub-
jective psychological experiences such as feelings of thwarted belonging and perceived burden-
someness in the aetiology of suicide (Joiner, 2005).
The importance of social context is evident in contemporary theories which explicitly assert that
suicidal behaviour is the result of an interaction between individuals and the social, historic, cul-
tural, political, and economic contexts in which they live (see Hawton & van Heeringen, 2009;
Nock, 2014 for an overview). Authors such as Möller-Leimkühler (2003) and Canetto and Lester
(1998) who attribute high rates of male suicide to gender norms understand that suicidal behaviour
is as much a socio-cultural phenomenon as it is a symptom of psychiatric illness.

Method
Participants
Purposeful sampling was used to recruit males between the ages of 18 and 25 years enrolled in the
final year of their undergraduate degree at a large university in the Western Cape, SA. We sent an
email to 241 male students enrolled in third-year psychology and physiology courses, inviting
them to participate in a semi-structured, face-to-face interview about their understandings of sui-
cidal behaviour. An R40 (USD2.62) meal voucher was offered as an incentive to participate. A
second email invitation to participate in the study was sent out 1 week later. Initially, 15 male
236 South African Journal of Psychology 47(2)

students responded to the email (8 from the third-year psychology course and 7 from the third-year
physiology course), yielding a 6.2% response rate. Two participants withdrew from the study. We
conducted interviews with the remaining 13 participants, and given the rich data generated from
these interviews, we decided not to recruit any further participants.
The participants were all between the ages of 20 and 25 years, with a mean age of 22 years. Four
participants disclosed having previously attempted suicide, five participants reported past episodes
of suicidal ideation, and four participants reported no history of suicidality. None of the partici-
pants expressed suicidal ideation or intention at the time of the interviews. The sample was ethni-
cally diverse; seven participants were White, four participants were coloured, and two participants
were Black. Six participants reported their home language to be English, four Afrikaans, one
Xitsonga, one Sesotho, and one English/Afrikaans bilingual. Almost all participants stated they
were Christian, except one who reported being agnostic and two who reported being atheists. Three
participants self-identified as gay.

Instruments
We used a semi-structured interview schedule to prompt participants to talk about their previous
experience of suicide, how they made sense of and understood suicidal behaviour among men,
perceptions about the social contributors to suicide, and their ideas for suicide prevention.
Participants were also asked to share their opinions in response to four vignettes that described
various situations in which males engaged in suicidal behaviour (i.e., suicide in response to aca-
demic pressure, unemployment, relationship problems, and mental illness).

Procedure
Interviews were conducted by the third author (a young White female post-graduate student) and
lasted between 90 and 120 min. Interviews took place at a time suitable for the participants in a
private interview room. The interviews were audio recorded and transcribed.

Ethics
The study received ethics approval from the relevant university Research Ethics Committee, and
participants gave written informed consent to participate. Participants were encouraged to seek
help at the Student Counselling Centre or call the 24-hr Psychological Crisis Service of the
University if they experienced psychological distress following the interview. For the purpose of
this article, pseudonyms were used for the participants.

Data analysis
The data were analysed using thematic analysis. Braun and Clarke (2006) define thematic analysis
as ‘a method for identifying, analysing and reporting patterns (themes) within the data’ in order to
produce a systematic and thick description of the data set (p. 79). The thematic analysis was per-
formed manually, following the process of encoding data as outlined by Braun and Clarke (2006).
The process of coding was inductive and data-driven; once themes emerged, we developed theo-
retical implications of the findings. During the interviews, participants expressed a number of
attitudes and perceived social norms based on their understanding of young South African men,
their perceptions of why men engage in suicidal behaviour, and their impressions of contemporary
South African society. We made sense of these data by drawing on the concepts of hegemonic
Bantjes et al. 237

masculinity (Connell, 2000), gender regimes (Connell, 1996), and thwarted belonging (Joiner,
2005).

Results
Restrictive masculine gender norms
Participants expressed a perception that high rates of suicidal behaviour among young men in SA
were related to ideals of hegemonic masculinity within the country. All participants reported feel-
ing under pressure to conform to rigid, narrow, and restrictive gender norms and traditional hegem-
onic ideals that men should be strong, heterosexual, protectors, and providers. Michael said,

If you are 30 or 40, you have to have kids, you need to buy your wife a brand-new house and you have all
these expectations from society itself. . . . From 18 to let’s say 25 you are under so much pressure . . . you
need to start fulfilling your roles now.

Participants said that they were expected to provide financially for their family. Richard said,
‘like your culture is saying the man is the provider of the family, the man is the stronger one and
everything’.
The young men in this study equated being a man with being in charge, having financial means,
and being independent. They expressed a desire to exhibit these masculine characteristics particu-
larly in the context of their romantic relationships. Themba expressed this by saying,

We are going out together . . . So you wanna be in charge and the person who is educated and all, who has
money, is like independent . . . (otherwise) you feel that you are not man enough.

Participants also described feelings of shame when they were unable to meet these social expec-
tations. James, for example, explained how he felt embarrassed and humiliated when he faced the
possibility of academic failure. His perception was that he was expected to achieve good academic
results in order to secure lucrative employment.
All participants affirmed a belief that the gender regime in SA prescribes that men should restrict
their displays of emotion, silence their fears, and hide their sadness. This requirement to ‘suffer in
silence’ was particularly marked when in the company of other men. Showing sadness, fear, and
vulnerability were associated with being gay, and hence feminine. Participants said that this gender
norm prevented men from accessing emotional support as their distress is invisible to others. Aasim
stated,

. . . it is easier for women to congregate and just have a ‘bitch-and-moan session’. I can’t say that men don’t
do the same, but it’s considered demasculinating (sic) for a man to express insecurity, to express failure, to
express fear.

Participants said that displays of emotion were considered feminine and were equated with being
gay. Kobus stated, ‘a lot of men will not want to go and express their emotions for fear of being
stigmatised as homosexual’.
Some participants expressed a perception that gay men have an advantage over straight men, as
their sexual orientation (i.e., being gay) affords them permission to express emotions more freely,
which in turn promoted their psychological health. Straight men were positioned as restricted and
compelled to be emotionally unauthentic. Kobus, a gay man, expressed this saying, ‘I feel like cry-
ing for straight men, because they can’t be who they want to be’. Another gay participant, Bongani,
238 South African Journal of Psychology 47(2)

echoed this perception by asserting that gender norms in SA prevented straight men from express-
ing tender parts of themselves and thus denied them opportunities for authentic relating. He said,
‘they can’t be the man they want to be in terms of maybe I want to be a bit softer, or maybe I want
to be expressing myself more in this way or that way’.

Heteronormativity
Participants expressed a belief that homophobic attitudes were widespread in SA, and that low
tolerance for deviations from heteronormative conventions isolated and stigmatised gay men.
Kobus described this by saying, ‘another big example would be young white Afrikaans males who
are homosexual, having nowhere to go and not being able to come out to their parents’.
Aasim, one of the gay participants, explained how his fear of disclosing his gay identity made
him feel like he had to repress his feelings and hide himself, leading to feelings of shame:

I had to come to terms with my sexuality, which I was aware of from a very young age. [ . . . ] That is many,
many years of repression and it manifests rot, it manifests deterioration in you, in a person’s character.

Similarly another gay participant, Bongani, explained how difficult it was for him to identify
himself as gay. He said, ‘Ok, I recently came out of the closet . . . and it’s still kind of difficult to
make peace with this . . .’.

Reluctance to access emotional support

Participants reported that many young SA men were reluctant to access formal sources of support,
such as psychologists, as it would amount to admitting a loss of control and an inability to solve
their problems on their own. They said that accepting help was a threat to their independence and
autonomy. Tebogo’s stated, ‘men always feel that they have to be strong and they have to sort of
carry the weight and just shrug it off and keep going’.
Participants stated that instead of seeking help, men who are distressed often withdraw and
isolate themselves, ignore and deny their problems, or engage in other self-destructive behaviours,
such as excessively using alcohol and drugs, engaging in risk-taking behaviour, or being aggres-
sive and violent. These self-destructive responses to psychological distress were described as
‘more manly’ and hence a socially sanctioned way to respond to anguish.
Several participants reported that, as young men, they often felt disempowered and silenced.
They expressed disdain for feminism as, in their view, the empowerment of women in SA had been
achieved by disempowering and marginalising men. Richard said, ‘the whole society is giving
woman all these equal rights and . . . that kind of takes the man off his podium, where I think he
should be’.
Participants spoke of gender empowerment as a zero-sum game in which the liberation of
women in SA could only be achieved through disempowering men. Participants described their
experience of dealing with empowered women as ‘challenging’ and ‘difficult’. Richard articulated
this saying, ‘we [men] feel inferior . . . So women when they do succeed, they succeed better than
men. So you might see it as a challenge’.

Feeling disconnected and displaced

Many participants described young South African men as being in a state of ‘limbo’; living between
the apartheid era and an as yet unrealised ‘new’ democratic and liberated SA. They stated that it
Bantjes et al. 239

was difficult for young men to form an identity in a society that itself suffered from what one par-
ticipant called a ‘fragmented identity’. Participants described feeling displaced, disconnected,
disorientated, and confused. James said,

I feel that sometimes as a young person it helps so much to have a set of values and norms and systems in
place that is constant. When that system is interrupted it creates confusion. It creates inconsistency in the
individual.

Some participants described a sense of incongruence between the values and attitudes expressed
by their parents and their experience of life in post-apartheid SA. This incongruence contributed to
the participants’ experience of displacement and confusion.
Some of the Black participants described a sense of discontinuity between the traditional cus-
toms, which they associated with their parents and the western ideas that they saw embedded in the
‘new’ SA. Richard said,

We have shifted from our culture to adopting the western stand . . . I think the influence of media and the
broken traditional ties. We are dispersed now, you are no longer living where you are born. You are moving
to some place like I am now. I’m studying here and I’m gonna adopt the culture here.

Disillusionment
Participants stated that they were disillusioned by the lack of political and economic transforma-
tion in SA and the state’s unfulfilled promises of education, employment, health care, and housing.
Tebogo, for example, argued that the disillusionment resulting from unmet expectations caused
many young people to ‘lose their way’. Other participants stated that the current education system
in SA was ‘killing’ young people, because it denied them realistic chances of access to tertiary
education and employment. Paul stated,

I think also our government is really failing our youth, because right now you go to tertiary level, there are
these colleges here and then at the end when you want to get a job, it is not recognised. It is of a low
standard . . . We need to up our education system so that we can get the jobs.

Exposure to violence
Participants described SA as a violent society that has desensitised them to violence and death. On
one hand, they spoke as if they were unaffected by death but simultaneously seemed to imply that
they felt physically unsafe. They said suicide was easy to imagine in a country where life seems to
hold such little value. Chris expressed this saying, ‘some people are desensitised to it (death) just
because of violence as well, like we see on TV and like the whole culture of South Africa is just
that it is another life’.

Escape from intolerable feelings

Participants reported that they understood suicidal behaviour as a way to avoid intolerable feelings
of shame, humiliation, and embarrassment. For example, Richard stated that a friend’s suicide had
been caused by an inability to tolerate and express the embarrassment of academic failure. He said,
‘I’ve heard a lot of people saying they can’t live with the humiliation’.
Participants attributed male suicidal behaviour to pressure to demonstrate masculine character-
istics such as being strong, powerful, independent, and financially successful, as well as an
240 South African Journal of Psychology 47(2)

expression of anger. Tebogo stated, ‘. . . with young men it is anger, their suicide is anger-based.
Anger at life, anger at a lot of things . . .’. Participants expressed a perception that men’s inability
to tolerate and appropriately express these emotions gave rise to self-destructive behaviour and
self-injurious acts. Tebogo stated, ‘I think men are ill-equipped to deal with their emotions a lot of
times. So they just bundle up and that (suicide) will be the end result’.

Inauthentic emotional expression

All participants said they believed men’s inability to authentically express emotions such as anger,
fear, and sadness contributed to poor psychological health and ultimately to self-destructive and
violent outbursts. Letsego articulated this perception by saying ‘. . . they [men] never ask for help
until a point where they crack . . . and it is just this huge, massive release whatever of cooped up
anger, frustration and shame’.
Participants said that it was difficult for others to determine when men were at risk of suicide
because males were able to conceal their distress and vulnerability. Their perception was that the
need to maintain the appearance of being in control prevented men from seeking help, which
placed them at risk of suicide.

Social isolation
Participants expressed a belief that suicidal behaviour was caused by a lack of close relationships
or by negative relationships, interpersonal conflict, and negative peer interactions. Several partici-
pants asserted that suicidal behaviour was associated with feeling socially isolated and unsup-
ported by others. Aasim stated, ‘I think why somebody would follow through (with suicide) is that
there is an immense sense of being cut-off from your reality . . . it’s just that your support doesn’t
seem accessible to you’.

Fostering connection and relationships

All participants stated that being socially connected and engaged in supportive relationships were
protective factors against suicide. They advocated for interventions that promote social engage-
ment and participation in social activities in order to foster a sense of belonging and an experience
of connectedness. They suggested that spending time with friends and participating in sport and
other organised activities could inoculate young men against suicide. Bongani, for example, pro-
posed that one way to deal with suicidal thoughts was to ‘just surround yourself with people ’cos
people carry people’. He supported his prescription for social interaction by making the following
biblical reference: ‘I read in proverbs where Solomon says that it is not good being in solitude or
something because the opinions and ideas of other people should get into your mind as well, not
only your own thoughts’.
Participants stated that suicide intervention strategies needed to include community develop-
ment, such as building sports facilities and youth centres, where young people could interact with
one another in positive ways and learn to take charge of their lives. Participants advocated for
suicide prevention strategies that focus on helping at-risk men hone interpersonal and relationship
skills. James, for example, said, ‘I think if one were to expect change or see change (in rates of
suicide), one would have to see it in attempts to address how people actually engage in their rela-
tionships’. Similarly, Michael stated that establishing intimate interpersonal relationships contrib-
uted to a decrease in his suicidal behaviour. He said, ‘since I have met my partner I haven’t touched
a blade once’.
Bantjes et al. 241

Many participants suggested that the way to reach men in distress is to work through the women
with whom they had intimate relationships, such as mothers, wives, and girlfriends. They implied
that their relationships with other males were characterised by competitiveness that made it diffi-
cult to demonstrate vulnerability or accept help from them. Letsego communicated this by saying
‘Guys don’t listen to guys. If a guy tells them something they would just be like “screw you.” Guys
listen to women they love, whether it’ll be wives or girlfriends’.

Accessing support on social media

Participants proposed that suicide interventions should focus on encouraging at-risk men to seek
psychological support and express their emotions in ways that are not self-destructive. They stated
that online social media could be effective tools for obtaining social support and fostering feelings
of connectedness. Bongani, for example, explained that Facebook and Mixit allowed him to com-
municate his distress to others and hence access support from his peers at times when he felt iso-
lated and suicidal. He said, it was easier to express emotions on social media than in person and
that this expression was cathartic. He said, ‘You can just release it all and the person won’t be there
to judge you’. The implication was that social media enabled men to express themselves in ways
that were not otherwise open to them because of their perception that gender norms were more
relaxed in cyberspace.

Discussion
We found that despite socio-political transformation in SA, some young men do not feel liberated
to deviate from traditional, rigid, and restrictive gender roles. Our participants stated that gender
norms in SA prohibited young men from directly expressing anger, emotional distress, and vulner-
ability. Instead, to achieve manhood, they needed to be academically successful and gain lucrative
employment. They described feeling pressure to live up to these masculine ideals and felt shame
when they failed to conform to these hegemonic norms. They also described how prescriptions to
conceal vulnerability and restrict emotional expression disconnected young men from each other
by preventing authentic relating. The gender roles they identified are akin to what has been
described as hegemonic masculinity (Connell, 2000) and are consistent with previous research
describing restrictive heteronormative masculinities in SA (Breckenridge, 1998; Conway, 2007;
Morrell, 1998, 2001; Swart, 1998).
Societies have rituals, policies, and practices that reflect and define gender roles and relations.
This ‘gender regime’ is reflected in the patterns of communication, division of labour, exercise of
authority, and allocation of resources within the society (Connell, 1996). Our participants described
the gender regime in contemporary SA as restrictive, demanding, and unforgiving of young men.
Their perception was that this gender regime did not tolerate weakness or failure and that being
part of the regime places one at risk of self-destructive behaviours and alienation from other men.
While rejecting the gender regime may be liberating, doing so would position one on the outside,
disconnected from society, and thus also at risk of suicide.
On one hand, our participants grew up in a country that now has a liberal constitution that pro-
tects gender equality. Yet, despite the rhetoric of gender equality, it appears that rigid and restrictive
ideas about masculinity persist unabated, resulting in a sense of disconnection and disillusionment
among some young men. For these young men, their social progress is impeded by a society where
women are empowered. Participants positioned themselves as marginalised, disempowered, and
restricted despite being among a privileged group of students attending a well-resourced university
in a country where men are still more likely to find employment than women. This finding has
242 South African Journal of Psychology 47(2)

particular salience for suicide prevention, as feelings of disempowerment, entrapment, and defeat
have been associated with suicidal behaviour (Taylor, Gooding, Wood, & Tarrier, 2011).
Our participants ascribed male suicidal behaviour in SA to a lack of social integration and to
feeling socially disconnected from one another and from social institutions. These perceptions
echo Durkheim’s (1897, 1951) notions of anomie suicide and egoistic suicide. Indeed, it has been
shown that extensive social, political, and economic transitions are associated with increased rates
of youth suicide (Cleary & Brannick, 2007). Similarly, in SA, Schlebusch, Vawda, and Bosch
(2003) observed that suicidal behaviour among Black South Africans is in part due to unrealised
social, political, and economic transformation.
None of the participants in our study attributed suicide to psychiatric illness, which has been the
focus of much research to date (Hawton & van Heeringen, 2000). Indeed, there has been renewed
interest in how interpersonal, socio-political, economic, and cultural factors, such as gender norms,
contribute to suicidal behaviour (Colucci & Lester, 2013; Möller-Leimkühler, 2003). For example,
Bhugra (2005) has described how sati can be understood as a form of non-psychiatric suicide
which is deeply embedded in socio-cultural factors and gender role expectations. Similarly, schol-
ars in SA have described how attempted suicide by young Indian women can be conceptualised as
a consequence of socio-cultural transition and gendered power relations (Wassenaar, van der Veen,
& Pillay, 1998). Suicide among women has long been understood as an assertion of power and a
way to resist gender norms (Counts, 1984) and is thus a political act performed to resist oppression,
marginalisation, and social restrictions. Brown (1986), for example, describes how in Aguaruna,
young men and women engage in suicidal behaviours as an assertion of personal autonomy and a
way to express anger and grief against societal constraints.
The idea that people who are disconnected and marginalised are at risk of suicide is congruent
with Joiner’s (2005) assertion that ‘thwarted belonging’ is a necessary condition for suicidal behav-
iour. Feelings of connectedness are the result of close personal relationships, family bonds, and
being accepted as part of a social group, while thwarted belonging and the experience of being
disconnected and isolated gives rise to suicidal behaviour (Joiner, 2005). Thus, social isolation,
being divorced, widowed, or living alone is a significant risk factor for suicide (McIntosh, 2002).
Participants proposed that suicide prevention initiatives should focus on fostering connected-
ness and relationships among men. They advocated for the use of social media in suicide preven-
tion. Indeed, there are reduced limitations on gender roles in cyberspace that allow individuals to
feel more autonomous, liberated, and free to experiment with different personas and sex roles
while bending gender norms (Cooper, McLoughlin, & Campbell, 2000; Ebo, 1998). Also, some
individuals are more inclined to self-disclose and express themselves more freely on social media,
a phenomenon termed, ‘The Online Disinhibition Effect’ (Suler, 2004). The apparent relaxing of
gender norms in cyberspace together with the online disinhibition effect may provide possibilities
for effective online suicide prevention interventions for young men in SA.
There are a number of limitations of this study, including the small sample size and the fact that
the participants were all young undergraduate students attending a well-resourced university.
Similar studies will need to be done in a variety of settings to establish if other groups of young
men in the country share the attitudes and perceptions expressed by the participants in this study.
The use of individual interviews to collect data and the fact that interviews were conducted by a
young White female may also have shaped what participants shared. It may be helpful for future
studies in this area to collect data via the use of focus groups and for interviews to be conducted by
male and female data collectors of different ages. This would seem to be important given the per-
formative nature of gender (Butler, 1994), and the possibility that participants in studies such as
this one may select what they choose to say based on who they perceive the audience to be and
their perception of what they are expected to say.
Bantjes et al. 243

Conclusion
The findings of this study bring into focus perspectives that need to be considered when developing
programmes to promote the health and well-being of young men in present-day SA. The perceptions
and attitudes expressed by the young men in this study raise questions about the extent to which the
gender regime within SA may hinder young men’s efforts to establish authentic relationships and
may precipitate feelings of disconnection and thwarted belonging, which may contribute to self-
directed violence. These data suggest that suicide prevention programmes directed at young men
need to focus on fostering connectedness and relationship building while challenging restrictive and
oppressive gender norms. The use of e-interventions may have particular application in this area
given what participants report about the facilitative role that electronic media play in enabling emo-
tional expression and accessing support. The use of e-interventions may have particular salience
given the young men’s perception of the restrictive gender regime in SA and their belief that gender
roles are more flexible in cyberspace. Traditional suicide prevention programmes typically focus on
a ‘four level approach’, which includes a strong emphasis on interventions aimed at recognising
risk, identifying individuals with psychopathology, and promoting access to psychiatric care (Hegerl
et al., 2009). The views of the young men in this study imply that suicide prevention programmes in
SA may need to move beyond the traditional focus on psychiatric risk factors to include addressing
socio-cultural factors such as exposure to violence, restrictive gender norms, and young men’s per-
ceptions that they are disempowered and marginalised in post-apartheid SA.

Funding
The author(s) disclosed receipt of the following financial support for the research and/or authorship of this
article: This research was partly funded by a Thuthuka Grant (Reference: TTK13070620647) from the South
African National Research Foundation (NRF) and a Career Development Grant from the South African
Medical Research Foundation awarded to J Bantjes.

References
Bantjes, J., & Kagee, S. (2013). Epidemiology of suicide in South Africa: Setting an agenda for future
research. South African Journal of Psychology, 43, 238–251.
Bhugra, D. (2005). Sati: A type of nonpsychiatric suicide. Crisis: The Journal of Crisis Intervention and
Suicide Prevention, 26, 73–77.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology,
3, 77–101.
Breckenridge, K. (1998). The allure of violence: Men, race and masculinity on the South African gold mines
1900–1950. Journal of Southern African Studies, 24, 669–693.
Brown, M. F. (1986). Power, gender, and the social meaning of Aguaruna suicide. Man, 21, 311–328.
Butler, J. (1994). Gender as performance: An interview with Judith Butler. Radical Philosophy, 67,
32–39.
Canetto, S. S., & Lester, D. (1998). Gender, culture, and suicidal behavior. Transcultural Psychiatry, 35,
163–190.
Cleary, A., & Brannick, T. (2007). Suicide and changing values and beliefs in Ireland. Crisis: The Journal of
Crisis Intervention and Suicide Prevention, 28, 82–88.
Colucci, E., & Lester, D. (Eds.). (2013). Suicide and culture: Understanding the context. Boston, MA:
Hogrefe Publishing.
Connell, R. W. (1996). New directions in gender theory, masculinity research, and gender politics. Ethnos,
61, 157–176.
Connell, R. W. (2000). The men and the boys. Los Angeles: University of California Press.
Conway, D. (2007). The masculine state in crisis: State response to war resistance in apartheid South Africa.
Men and Masculinities, 10, 422–439.
244 South African Journal of Psychology 47(2)

Cooper, A., McLoughlin, I. P., & Campbell, K. M. (2000). Sexuality in cyberspace: Update for the 21st cen-
tury. CyberPsychology & Behavior, 3, 521–536.
Coovadia, H., Jewkes, R., Barron, P., Sanders, D., & McIntyre, D. (2009). The health and health system of
South Africa: Historical roots of current public health challenges. The Lancet, 374, 817–834.
Counts, D. A. (1984). Revenge suicide by Lusi women: An expression of power. In D. O’Brien & S. W.
Tiffany (Eds.), Rethinking women’s roles: Perspectives from the Pacific (pp. 71–93). Los Angeles:
University of California Press.
Delius, P., & Glaser, C. (2002). Sexual socialisation in South Africa: A historical perspective. African Studies,
61, 27–54.
Durkheim, E. (1897). Le suicide. Etude de sociologie. Paris: Felix Alcan.
Durkheim, E. (1951). Suicide: A study in sociology. Translated by JA Spaulding and G. Simpson. London:
Routledge, 8, 210.
du Toit, E. H., Kruger, J. M., Swiegers, S. M., van der Merwe, M., Calitz, F. J. W., Philane, L., & Joubert, G.
(2008). The profile analysis of attempted-suicide patients referred to Pelonomi Hospital for psychologi-
cal evaluation and treatment from 1 May 2005 to 30 April 2006. South African Journal of Psychiatry,
14, 20–26.
Ebo, B. (1998). Internet or outernet? In B. Ebo (Ed.), Cyberghetto or cybertopia (pp. 1–12). Westport, CT:
Praeger Publishers.
Hawton, K., & van Heeringen, K. (2009). Suicide. Lancet, 373, 1372–1381.
Hawton, K. E., & van Heeringen, K. E. (Eds.). (2000). The international handbook of suicide and attempted
suicide. Chichester, UK: John Wiley.
Hearn, J. (2007). The problems boys and men create, the problems boys and men experience. In A. Strebel,
K. Ratele, N. Shabalala, & R. Buikema (Eds.), From boys to men: Social constructions of masculinity in
contemporary society (pp. 12–32). Cape Town, South Africa: University of Cape Town Press.
Hegerl, U., Wittenburg, L., Arensman, E., Van Audenhove, C., Coyne, J. C., McDaid, D., . . .Bramesfeld, A.
(2009). Optimizing suicide prevention programs and their implementation in Europe (OSPI Europe): An
evidence-based multi-level approach. BMC Public Health, 9, Article 428.
Joe, S., Stein, D. J., Seedat, S., Herman, A., & Williams, D. R. (2008). Non-fatal suicidal behavior among
South Africans. Social Psychiatry & Psychiatric Epidemiology, 43, 454–461.
Joiner, T. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.
King, M., Semlyen, J., Tai, S. S., Killaspy, H., Osborn, D., Popelyuk, D., & Nazareth, I. (2008). A systematic
review of mental disorder, suicide, and deliberate self-harm in lesbian, gay and bisexual people. BMC
Psychiatry, 8, Article 70.
Mager, A. K. (1999). Gender and the making of a South African Bantustan: A social history of the Ciskei,
1945–1959. Oxford, UK: James Currey.
Mayer, P., & Mayer, I. (1970). Socialisation by peers: The youth organization of the Red Xhosa. In P.
Mayer (Ed.), Socialisation: The approach from social anthropology (pp. 159–189). London, UK:
Tavistock.
McIntosh, J. L. (2002). USA suicide statistics for the year 1999: Overheads and a presentation guide.
Washington, DC: American Association of Suicidology.
Möller-Leimkühler, A. M. (2003). The gender gap in suicide and premature death or: Why are men so vulner-
able? European Archives of Psychiatry & Clinical Neuroscience, 253, 1–8.
Moosa, Y., Jeenah, Y., Pillay, A., Vorster, M., & Liebenberg, R. (2005). Non-fatal suicidal behaviour at the
Johannesburg General Hospital. African Journal of Psychiatry, 8(3), 104–107.
Morrell, R. (1998). Of boys and men: Masculinity and gender in Southern African studies. Journal of Southern
African Studies, 24, 605–630.
Morrell, R. (2001). From boys to gentlemen: Settler masculinity in colonial Natal, 1880–1920. Pretoria:
University of South Africa Press.
Niehaus, I. (2012). Gendered endings: Narratives of male and female suicides in the South African Lowveld.
Culture, Medicine, and Psychiatry, 36, 327–347.
Nock, M. K. (Ed.). (2014). The Oxford Handbook of Suicide and Self-Injury. Oxford, UK: Oxford University
Press.
Bantjes et al. 245

Ratele, K. (2008). Masculinity and male mortality in South Africa. African Safety Promotion: A Journal of
Injury and Violence Prevention, 6(2), 22–35.
Schlebusch, L., Vawda, N., & Bosch, B. A. (2003). Suicidal behavior in black South Africans. Crisis: The
Journal of Crisis Intervention and Suicide Prevention, 24, 24–28.
Seedat, M., Van Niekerk, A., Jewkes, R., Suffla, S., & Ratele, K. (2009). Violence and injuries in South
Africa: Prioritising an agenda for prevention. The Lancet, 374, 1011–1022.
Skegg, K., Nada-Raja, S., Dickson, N., Paul, C., & Williams, S. (2003). Sexual orientation and self-harm in
men and women. American Journal of Psychiatry, 160, 541–546.
Suler, J. (2004). The online disinhibition effect. Cyberpsychology & Behavior, 7, 321–326.
Swart, S. (1998). ‘A Boer and his gun and his wife are three things always together’: Republican masculinity
and the 1914 rebellion. Journal of Southern African Studies, 24, 737–751.
Taylor, P. J., Gooding, P., Wood, A. M., & Tarrier, N. (2011). The role of defeat and entrapment in depres-
sion, anxiety, and suicide. Psychological Bulletin, 137, 391–420.
Wassenaar, D. R., van der Veen, M. B., & Pillay, A. L. (1998). Women in cultural transition: Suicidal behav-
ior in South African Indian women. Suicide and Life-Threatening Behavior, 28, 82–93.