Acknowledgements Definitions Introduction Working with men Starting work with men Effective approaches Sexual development and function Common sexual problems Resources and organisations

	Finding out about men and sexuality
	ACTIVITY Understanding men
	ACTIVITY Enjoying sex
	ACTIVITY Men's beliefs about sex
	ACTIVITY Three-way role play
	Improving communication
	ACTIVITY Talking about sex
	Sensitive issues
	ACTIVITY Working on sensitive issues
	ACTIVITY Preparing to deal with disclosure of sexual abuse

Finding out about men and sexuality

It is important that anyone planning to work with men on sexual health first looks at their own ideas, assumptions and feelings about sex and sexuality. It is important to know what we think and feel, and to be able to step back from personal feelings and emotions in order to consider other people's needs.

 
 
Before starting to work with men, it is important to remember that all of .us are sexual beings ourselves. What we say and do to others when we are working on sex and sexuality is influenced by our own thoughts and feelings. There are issues that we may be unsure about or embarrassed about. This section suggests some exercises which may help men and women who are talking to others about sex and sexual health feel comfortable about the issues.

This activity aims to help you think about possible approaches to sexual health work with men in your community. Find a quiet space and time to think about the following questions. After you have done this, if possible, ask a colleague to do the same. Then discuss your answers.  Questions    What are the main concerns about sex and sexuality among the men you know? Are your concerns about their sexual health the same as theirs?  How do the men that you know talk about sex? Do they talk differently about sex to different people or in different situations?  Do different groups of men that you know have different attitudes, behaviours, values and language about sex and sexuality?  Think of any assumptions that you might be making about how the men that you know think, feel and behave about sex. For example, do you assume that they are sexually active, heterosexual or have only one sexual partner?  Do you already talk about sex with the men you work with?  Do you have any concerns about the way that the men that you work with talk or behave about sex, relationships, and health?  What do you like about the way that the men that you will be working with deal with sex, relationships and health?

ACTIVITY ENJOYING SEX This activity aims to encourage men to begin thinking about sexual health as something that: they can choose and influence. It can be done with a group of men or one-to-one. It is useful for the person who is facilitating this exercise to have done the exercise with colleagues first. Some men assume that enjoying sex comes naturally, and that some men are naturally good lovers and some are not. They may not have, had the chance to think about the reasons for this. In fact, most men can change and improve their sexual lives if they want to, and if they are helped to. 1  Ask the group to think: What would be the ideal situation for having sex for you? Where, what kind of sex, who with, and when? They do not have to answer out loud. 2 Then ask the group to think about sexual experiences from their past. What made the good times good? What made the bad times bad?  Encourage them to think in detail about the experiences - about: what they or their partners said or did, and how they were feeling. 3  Now ask each man to write down three things that would help him to enjoy sex more. 4  Ask men to go away and try to make these three things happen. If appropriate, ask them to talk over their ideas with their partners. If the men are willing, you can discuss what changes this activity has made to their relationships when you meet at a later date.

This activity aims to focus on what makes men the way they are. It encourages you to think about needs and strategies for working with men on sexual health for the first time. It helps you develop your own list of what men need to know. There are no right or wrong answers. You can do this activity alone or in a group with other workers.    1 On your own or in a group, look at some of the following statements about men's beliefs about themselves and their sexuality.    In general, men learn to:    hide certain kinds of feelings be independent and not ask for help avoid talking about. personal matters compete with each other be brave and strong, and take risks have a need to prove their 'manhood' measure their value by their ability to earn money and support their family distinguish between a public and a private self. About sex, men:   pretend they know all about it feel that having sex keeps them healthy find it hard to talk about it seriously feel that their sexuality is uncontrollable feel the need to perform find it difficult to be intimate use it as a way of getting close or getting comfort use it as a way of dominating someone else and feeling powerful repress their softer sensual side because it is seen as feminine.     2  Ask yourself the following questions:  Are any of these statements true for the men you will be working with? What further information will you need to get a more accurate picture of the possible influences on the men you know? Are any of these statements true of some men and not others? 3  Do this activity again, but think about women instead of men. 4  Think about what the main differences are between your answers. 5  Discuss your answers with someone you work with and see whether you have similar or different ideas.

If you are working with a group of men, it is likely that some men will want to talk to you privately about their concerns. This exercise gives workers a chance to practise talking about sex and sexual behaviour with men in one-to-one situations.  TIME               At least 90 minutes  MATERIALS      Paper and pen for the observer    This activity is done in groups of three workers. Each worker has a role: a man who wants to talk to someone, a worker, and an observer.  1  Decide who will play each role.  2  The 'man' chooses a problem from those listed below (or you can make up your own). He then thinks of an underlying problem, which is connected to the problem he wants to talk about, but which he is nervous of talking about.  3  The man and worker act out a role play for 10 minutes. The man with the problem talks about the problem, but tries not to reveal the underlying problem. The worker has to find out what the underlying problem might be. He or she must try to address both the problem mentioned and the underlying problem.  4  The observer watches and says nothing during the role play. He or she notes down what the worker is doing and what effect this has on the man.  5  When the role play has finished, the worker tells the observer what he or she thinks is the underlying issue and what he or she has done to help.  6  Then all three discuss what has happened (in their role) and describe how they feel. Did the man feel that his problems were understood? Was the information and support given useful?  7  Come out of your roles. Discuss what you have learned. What worked and what didn't work? 8  Change roles and use other problems until everyone has had a turn in each role.  Problems to discuss:   You are married and travel away from home for your work. You have sex with other partners and are worried about what will happen if your family finds out. You can't get 'satisfaction' with your wife. You want to know what kind of help she could get. You have made several visits to the clinic because you think you have an STI. The doctor cannot find anything wrong. Your friends laugh at you because you have a small penis. You want to know how you can make it bigger.

Improving communication

One of the most useful ways to work with men on sexual health is to talk about feelings. Talking can be the best medicine there is when it comes to dealing with sexual worries. Talking about sex may be hard to begin with but it gets easier with practice.
 

	Better communication between sexual partners is likely to make sex itself better because both partners will learn more about how to please each other.
	Talking can reduce anxiety about disease or unwanted pregnancy.
	If problems in a sexual relationship are discussed, they are less likely to affect other aspects of life, and problems in other aspects of life are less likely to cause problems in sexual relationships.
	Women often like men who talk and who are willing to take their share of responsibility.

ACTIVITY TALKING ABOUT SEX The aim of this activity is to help workers get used to talking about sex and hearing others talk about sex. Try this activity with a colleague. It is important that you both agree that what you each say will be kept in complete confidence. 1  Choose one or more of the topics below. Talk about it for five minutes while your colleague listens to you without interrupting. Say as little or as much as you want. The listener should give their full attention. They can make notes if they wish, but it is important to give most attention to you. 2  After you have finished, change roles with your colleague. Listen for five minutes to your colleague. 3  After you have both finished, discuss how it felt to do the talking and the listening. It is important to focus on the feelings of talking and listening, rather than on the topic you were talking about. Being aware of your feelings as you talk can help you think about how the people you may talk to in the future will feel. Being aware of your reactions as a listener is also useful for learning about any strong reactions, fear or prejudices you have. Possible topics   What you like most about sex What you find most difficult about sex The first sexual feeling or experience you can remember The first sexual experience you can remember with another person The messages picked up from your mother and father about sex  The first time you masturbated What you like best about your own body How you feel as you look at and touch a condom (do this by using a real condom).  Or, you can make up your own topic - it can be anything at all to do with sex and feelings about it.

ACTIVITY WORKING ON SENSITIVE ISSUES This activity aims to help you if you are talking to men about sensitive issues, such as rape or sexual abuse. It encourages you to think about what you may find difficult to talk about and think about how you may respond in a helpful way.   1  Use the following questions to help you decide which issues you feel you can address and which may be too difficult. 2  Talk over your answers with colleagues. 3  Discuss what support you have if you are faced with an issue you do not feel comfortable with. Questions   Why is work on sexual health important to you?  Have you done any thinking about your own sexuality or sexual life? How do you feel generally about talking to others about sexual matters.  How do you feel about talking to others about your feelings? What aspects of this work are you unsure of? Are there any areas of your own sexuality or sexual life which you do not feel prepared to discuss? Why is this? How have you reacted in the past when an issue that is difficult for you personally has come up? What makes you a good person to work on these kinds of issues?

Rape and unwanted sex 
Any unwanted sex is abusive to the person who is being forced to have sex, whether or not physical violence is used. Rape is the sexual penetration of a person's body against their will. Both men and woman can be raped (men can be anally raped).

Although most men never rape anyone, many have sexual fantasies about controlling, overpowering or hurting women or other men. These feelings have a number of origins. Men may have experienced being overpowered themselves (though not necessarily sexually). Men who are abusers are likely to have seen others being overpowered and possibly been frightened by it. 

Men are not to blame for having these feelings, but they are responsible for making sure that they do not hurt others. Giving men the opportunity to talk about these feelings and where they might come from can be important for preventing rape. Men who have raped need the opportunity to talk about what they did and how they felt, to help them avoid doing it again.

ACTIVITY PREPARING TO DEAL WITH  DISCLOSURE OF SEXUAL ABUSE Sexual abuse is likely to be one of the hardest issues that you may face, and it is important to be prepared. This exercise gives you time to think about what you may do and say, and a chance to practice with colleagues.    Discuss your own feelings about sexual abuse with colleagues or friends. Think about what you might feel and do in such situations. Think about how you might react if someone tells you they are being sexually abused or are abusing someone.  If you yourself have been raped, or abused in another way, consider what support you may need when a man tells you about his experiences of sexual abuse. Discuss with colleagues in advance what you will do if someone tells you that they have been abused or have abused someone else.  Find out the legal situation. Find out if other organisations deal with sexual abuse locally, and whether they can support you or whether you can refer men to them. It is often better to contact someone for help, rather than to try to do more than you are able.

DEALING WITH DISCLOSURE OF SEXUAL ABUSE 
 

	If you are willing to deal with sexual abuse in your organisation, put up posters or distribute other materials telling people what you will and will not do. Make it clear that you will preserve confidentiality.
	If someone talks to you about abuse, listen carefully to what they are saying and let them know that you are taking them seriously. Your initial reaction is important. People revealing a secret are often very afraid of being disbelieved or judged. Some people, particularly men, have been known to keep their experience of abuse secret for years.
	Put aside your personal feelings as much as possible. Try not to decide that the person is a victim, or whether they have done right or wrong.
	If you cannot deal with the case yourself, make sure that the person talking to you knows that you will find someone else who can.
	Don't panic yourself by expecting to deal with this on your own. Simply by getting appropriate help you will have done someone a great service.