Violence and Gender

If one bothered to notice, we would see that most reports about "violence" are really stories about "violent males." That is not to say that females aren't violent. It is just that the male predominance is overwhelming. Yet we speak of these events in gender-neutral language as "school" violence, or "teen violence," or "terrorist" violence. Why is a behavior that is clearly identified with one gender never spoken of with reference to that gender? Because gender-neutral language is used to describe a behavior that is the norm.

Is it testosterone? If it only was that simple! While the male hormone is involved in aggressive behavior, even increased by it, there is no blood level that is predictive or causative. It simply facilitates the electrical signal in the brain that is already flowing. In other words, testosterone turns up the rheostat, but the switch is already on. So what comes first? Let's look at another species to get perspective. In Kenya, female spotted hyenas are bigger, more muscular and more aggressive than males. In fact, they are socially dominant. Female hyena babies, however, taken out of their natural environment are still larger and more muscular than the males, but find it difficult to assert their dominance even in the presence of their higher testosterone levels. The missing factor? There was no established social system to model behavior!

So... violence is more than just testosterone and more than the natural instinct for boys to be boys. It is a complex behavior dependent upon social context and power inequities.

Violence is different depending on the gender of the victim. Male to male violence is public - on the street; in a bar room brawl; acting out on the job; or driving while intoxicated. Male to female violence is private, and occurs in the home. The voices of violent men are heard in the jails and criminal justice system. The voices of terrorized women are not heard as such but as complaints heard in the health care system. We see male "criminals" and "sick" women.

But is the criminal justice system treating a medical condition...or is the health care system treating a social condition? In the papers and the courtrooms, we hear about assault, beating, rape and murder. In the courtrooms men are declared alcoholics, substance abusers and sociopaths. But in the health care system we hear about fatigue, insomnia, palpitations, shortness of breath, headache, body pain, etc. We diagnose chronic pain syndromes, somatization, STDs, HIV, depression, and unwanted pregnancies in women, as well as alcoholism and substance abuse. Commonly seen obstetrical problems are seen as just that by obstetricians. Yet, a Cook County Hospital study showed that 46.3% of maternal mortality was due to domestic violence. Battered pregnant women are also at increased risk for pre-term labor, low infant birth weight, fetal injury and fetal demise. Girls surviving childhood sexual abuse have unique mental health issues such as dissociative disorders, self-mutilation, and eating disorders. Where else in medicine do we treat the disease without addressing the etiology?

So, what's the bottom line? Gender analysis is not just about women... men have gender too! Whether in health care or criminal justice, a gender analysis is desperately needed to start holding boys and men accountable. It is crucial if we are to change the cultural norms that foster patterns of violent behavior. While women need to speak up, we must also, as a society, speak about men being violent.

For another take on male violence, see Save the Males, by Jed Diamond, Ph.D.

To learn more about Eileen Hoffman, M.D., check out her expert voice page, or visit: www.dreileenhoffman.com