Assisting men to appreciate themselves as sexual beings capable of creating human life will help them protect their own health and well-being while safeguarding their partners and potential children. My experience conducting in-depth interviews1 and focus groups2 with men aged 16-30 has convinced me that it is possible to enhance young men's mindfulness about their sexual and procreative identities; the challenge for reproductive health care providers and educators is to explore creative ways of doing so.
Individuals construct and express their identities by interacting, reflecting and telling personal stories; they rely on language to make sense of their relationships and figure out who they are. Thus, without the concepts and linguistic tools to capture the nuances of their everyday sexual and procreative lives, many young men will have muddled and fragmented identities in these areas.
If professionals are to help young men develop—and in some cases transform—their identities, they should pursue three objectives. First, they should expose young men to a set of theoretically informed ideas that allows them to identify and represent aspects of their sexual and procreative lives in practical ways. Second, they should emphasize substantive themes encouraging men to recognize their ability to have sex and create human life as a powerful life force interwoven with other aspects of their lives. Third, they should provide young men with private guidance and diverse group opportunities to construct and reflect upon their personal stories about procreative issues.
The cognitive and social sciences provide a foundation for those wishing to improve young men's self-awareness and decision-making abilities about relationships, sex, contraception, pregnancy and parenthood. Neuroscientists, for example, emphasize that the adolescent brain is essentially "under construction."3 In particular, the frontal cortex, which affects individuals' capacity to control impulses, make reasoned judgments and execute plans efficiently, is still developing. Although the use of modern imaging technology to assess brain function is still in its early stages, this picture appears to be consistent with the popular perception that youth—especially young adolescents—are more likely than adults to view themselves as invincible and exercise poor judgment in assessing personal risks. Granted, "irrational" or impulsive behavior is not confined to young persons, nor is it impervious to influence by educational or behavioral interventions. However, because the main decision-making center of the brain continues to develop into young adulthood, and U.S. youth are confronted with making emotionally charged decisions about sex and reproduction in a highly sexualized culture, special initiatives to strengthen young persons' self-reflective and decision-making skills seem uniquely warranted.
Social scientists also remind us of the profound importance gender norms and ideologies play in young men's development.4 Concerns about being perceived as too feminine or having homosexual tendencies cloud the way a significant number of young males develop their sense of self and communicate within and about intimate relations. All too often, this perspective influences young men's approach to romantic relationships, sex, paternity and fatherhood.
MALE PROCREATIVE IDENTITY: A FRAMEWORK
As a sociologist, I have sought over the past decade to develop a social psychological framework for conceptualizing men's procreative identities.5 Most recently, Sally Hutchinson and I used data from in-depth interviews with 70 young men to refine this conceptual framework, grounding it in empirical data.6
Procreative consciousness, the core concept, captures the varied ways men cognitively and emotionally experience being aware of their ability to create life. Perhaps the most important way this consciousness is expressed involves men's experiences with responsibility issues related to procreation and prospective fatherhood. For example, responsibility issues can come into play when men purchase or use condoms, or develop concerns about financial and child-care obligations for a child not yet born. Men experience their awareness of their ability to procreate most directly as part of their "wide-awake" reality, or working memory. This awareness also resides in men's latent consciousness, or long-term memory, where an event, image or passing thought can trigger it.
This multidimensional concept is defined by several properties. First, knowledge about different aspects of procreative ability is relevant. Men can be aware of their own as well as others' procreative potential, their degree of potency and whether their ability to procreate has ever been confirmed through their involvement in a pregnancy. Second, men can experience a range of emotions with varying levels of intensity because of procreative events. Third, a temporal element captures the duration and frequency with which men experience their procreative consciousness. Fourth, men can imagine their potential children's physical and personality characteristics.
The framework also draws attention to the many ways men experience their procreative consciousness. Some occur in specific situations, such as when men lie naked next to a partner or buy condoms. Others are not directly tied to a specific encounter: For example, men may have a keen awareness of their procreative ability throughout the months of negotiating with their partner whether they should try to have a child or during their partner's pregnancy. Finally, this model differentiates between awareness that is due to men's own conviction and awareness that is tied to a particular partner's preferences, expectations and needs.
This framework may be applied to develop strategies that service providers and educators could use to enhance young men's self-awareness. Because professionals may interact with young men in a variety of settings, there is no standard way to expose men to relevant themes. In some instances, professionals may provide an initial group workshop or one-on-one session to explain different concepts, then ask young men questions designed to elicit their thoughts and stories related to these concepts. At other times, professionals may ask men to talk about their experiences first, then use their experiences to illustrate different elements of the framework. To highlight some of the possibilities, I summarize aspects of these areas and comment on programmatic issues relevant to assisting young men to achieve a more mindful perspective.
In addition to providing standard testing and information regarding sexually transmitted diseases and other reproductive health concerns, programs should consider offering young men a chance to reflect on their broad life goals and dreams, as well as their experiences with and orientation toward sex and reproduction. Having young men initially talk about their goals affords them an opportunity to see their sexual and procreative identities within a larger context. Males can then be asked to describe when they first learned about their ability to procreate and how this knowledge has evolved in connection with their romantic partners, sexual encounters and procreative identities. When young men share personal stories in this way, it can heighten their awareness of their beliefs, feelings and experiences, encoding them into long-term memory. This may be most likely if their reflections are closely linked with an emotional response. The related challenge, of course, is to inspire men to make procreative issues relevant to the way they see their worlds and think about their responsibilities.
Gender norms influence how young men orient themselves to sexual partners and girlfriends, and men's procreative consciousness is sometimes affected by how they define a potential or actual sex partner (e.g., casual or serious girlfriend, "friend with benefits," hookup).7 Creating opportunities for young men to reflect critically on how they have perceived and treated female partners is thus crucial. Discussions should highlight issues about gender relations, commitment, contraception, unplanned childbearing and fatherhood. Young men can be prompted to think about and articulate the qualities they would like in a partner, including the qualities they would want in the mother of their prospective (or actual) child.
Most important, initiatives to promote male self-reflection about relationships must address respect for women and femininity more generally. Encouraging young men to define "respect" while having them critically evaluate their own behavior is one way to initiate discussion about how they treat females. Young men's mistrust of females should be explored, because young men often profess that a female's betrayal has had a lasting effect on them.8
If males' sexual and reproductive needs are to be approached holistically, then various issues associated with fathering need to be addressed, including males' experiences with fathers, current paternal role models, philosophies of fathering and fatherhood readiness, and visions of the children they may eventually or already have. Although addressing these areas falls under the purview of the diverse male responsibility programs that have emerged in the United States,9 men participating in a wide range of programs and classes can be targeted and asked to contemplate some or all of these matters to sharpen their relationship, sexual and procreative identities.
Young men should be encouraged to talk about the positive and negative aspects of their involvement with their biological father and any surrogate father figures. Relatedly, they should be asked to identify and describe persons whom they believe are ideal fathers, or at least someone they believe comes the closest. Having men think about persons they know as well as persons in the public eye can be useful. Discussions about role models can be tied easily to inquiries about the fathering philosophy young men hope to employ. Asking men to be specific and offer hypothetical examples should make this experience more realistic. Moreover, these discussions will be most effective if professionals get young men to think and talk about the feasibility of enacting their fathering philosophies in realistic situations. These scenarios need to take into account not only the practical realities of family life within particular homes and neighborhoods, but also social policies involving child custody, support and visitation. Such conversations are important because most young men who are not fathers have trouble comprehending the challenges that unwed fathers face in being involved with their children if the children live apart from them. They also typically have only a superficial sense of their potential financial responsibilities and how their limited human capital will affect their fathering.
An issue that should be coupled with men's fathering philosophies is their sense of readiness to become a father. Inquiring about men's level of readiness while discerning the reasons for their views can be instructive. Attention should go to how men focus on their own interests, those of their partner or the consequences for a potential child. Ideally, asking men to visualize their future children will help them create a more tangible sexual and procreative self-image.
PROMOTING AND USING SELF-NARRATIVES
Given the right circumstances, young men are willing to share, and are capable of sharing, in-depth accounts of their relationship, sexual and procreative experiences. Although securing detailed, sometimes emotionally laden stories from participants is typically associated with scholarly qualitative research, health care providers and educators can adapt similar strategies to facilitate young men's personal storytelling. Professionals serving as consultants, counselors or facilitators are more likely than researchers to interact with young men in an applied fashion. Consequently, they can listen and respond to men's narratives more proactively, working to help men sharpen and modify their self-awareness. Professionals' degree of success will be tied closely to the rapport and trust they establish with young men, as well as their ability to secure young men's time commitment. As in research studies, ensuring anonymity will often be critical. Although I have yet to integrate my framework into a clinic or programmatic setting where young men participate, I see a range of exciting possibilities for how self-narratives about sexual and procreative experiences can be fostered, studied and used as instructional devices in these settings.
Although one-on-one counseling may be the best setting for deeply personal and thorough self-narratives, the group synergy in informal workshops with 5-12 men also can be conducive to storytelling and sharing, albeit less elaborate and perhaps less intimate. Group activities often prompt significant introspection for both the speaker and other participants. Time constraints will limit the amount of attention that can be given to any one person's story. However, individuals leading groups that meet regularly will have the luxury of making extensive use of a self-narrative approach. Groups comprising strangers may elicit the most intimate disclosures, but it is not clear whether the need to present a masculine self10 will be stronger in groups of strangers or of friends and acquaintances. Facilitators interested in promoting the effective use of self-narratives as a means to encourage young men to relate their experiences, particularly within a group context, may expose them to transcripts of material drawn from participants in qualitative research interviews. Exposing young men to stories conveyed in a vernacular they recognize is probably important.
Providers and educators might rely on this approach to facilitate discussion when young men are reluctant to open up. Likewise, enlisting a young man to role-model an open style of self-disclosure could set the tone for others. Obviously, it will be crucial to address young men's possible concerns about having school or neighborhood peers knowing intimate details about their lives. Finally, the gender composition of groups needs to be factored into programming strategies. Although young males probably will feel most comfortable telling their life stories in an all-male group, supplemental efforts should include mixed-gender sessions where males can tell their stories while listening to those of young women. Mixed groups potentially can offer males a unique opportunity to process females' perspectives in a setting other than that of passionate, emotionally complex and awkward romantic encounters.
In one-on-one exchanges, guiding young men to talk about their experiences from a chronological perspective may be the best way to sharpen their awareness of their development while enabling them to make connections between the relationships, life events and feelings they have experienced. This approach is most likely to benefit older adolescents and young adult men, who typically have a broader set of experiences than young adolescents. Creating an environment where it is acceptable, perhaps even normative, for a young man to speak with a professional about a range of issues is critical. Professionals need to convince young men that their health and well-being (and those of others) necessitate that they recognize the link between their sexual and procreative identities, as well as the association between their procreative and fathering identities.
Getting young men to tell their stories is only half the battle. Helping them develop a state of mindfulness requires teaching them how to think about their experiences systematically, an experience foreign to many. They might, for instance, be prompted to discern and evaluate properties and motives embedded within their stories. How their stories are organized is one important property: Are they stable, progressive or regressive?11 Some narratives suggest a stable pattern, where little change has occurred during a particular time frame. Progressive and regressive narratives, by contrast, indicate that a person has experienced a change in some aspect of life—for instance, in the amount of time he spends thinking about his ability to procreate or in his interest in moving away from one-night stands and toward more committed relationships.
In my research, I ask young men to describe their experiences with learning that they could make someone pregnant if they had sex with her. After exploring their initial reaction to this knowledge, I ask them to discuss when and how that awareness has manifested itself. From these questions, it is easy to segue into questions about their relationships and fertility-related experiences.
Interviewing strategies that enable men to make connections between their former, current and possible selves are helpful in getting men to think systematically about their sexual and procreative identities. Having men think of their lives from a life-course perspective can force them to deepen their appreciation for how they have developed and how their experiences in different relationships have shaped their perspectives and actions. Although techniques other than the self-narrative approach may be more suitable to use in particular settings and programs, providers and educators should experiment with using a storytelling strategy to strengthen young men's personal insights about their identities related to sex and procreation. My qualitative interviews suggest that many young males are receptive to thinking about and sharing their life stories.
To foster providers' and educators' interest in getting young men to talk about their experiences, I share a sampling of questions that professionals could adapt to their specific community, site and clientele. Some are designed to promote life-story narratives:
• How did you first learn about your ability to get a girl pregnant? How did you feel about it then? How often have you thought about your ability to create a child since then? How do you feel about it now?<
• Would you please describe your history of hanging out and having relationships with girls or women?
• *Describe in as much detail as possible all the important ways in which you have talked about sex, contraception, pregnancy, abortion, miscarriage and parenthood issues with your partners over the years.
• Would you talk about any major experiences (turning points) in your life that drastically changed how you see girls or women? yourself as a sexual person? yourself as someone who could become a father now?
• Describe any experiences you've had with a girl or woman telling you that she might be pregnant with your child. How did you feel?
• Describe your relationship with your father over the years and how it has changed (or the person you feel acted like a father to you while you were growing up).
Other questions are intended to elicit reflections about specific issues:
• What do you believe your fathering philosophy will be if you become a father? How do you plan to treat your children? What kinds of values will be important for you to instill?
• Can you identify and describe someone you know who you believe is an ideal father? How about celebrities?
• How ready are you to become a father? Why?
• Can you describe any pictures you've created in your mind of what your children might be like?
A critical reason for asking these questions is to help young men contemplate their readiness to procreate and assume various fathering roles. Meanwhile, exposing them to concepts and terms such as procreative consciousness and responsibility, fatherhood readiness, ideal father, pregnancy scare, child visions, fathering philosophy and turning points can provide them with a framework to ground their cognitions and storytelling. Although the approach I have outlined can benefit men of varying ages and circumstances, it would be ideal if young males had these opportunities prior to becoming sexually active.
MAKING IT HAPPEN
In a reproductive health environment with limited resources, how feasible is it to promote young men's mindfulness in the ways I have outlined? Because circumstances vary greatly from place to place, and elements of my framework can be introduced to varying degrees, I can comment only generally on the practicality of implementing my ideas.
Some professionals committed to this task will no doubt face challenges securing and coordinating the necessary resources. A key concern is whether persons committed to and capable of working effectively with young men are already involved with a particular reproductive health organization. If so, then the start-up costs may be minimal, and significantly less than if someone must be recruited for this assignment. Similarly, if organizations and programs already cater to young men, they will be better positioned than groups that heretofore have focused primarily or exclusively on female clients. The latter will need to address the well-known obstacles to making reproductive health care more appealing to men.12
Organizations situated within major urban areas or university towns may have a decided advantage over sites in other locations, because they will have opportunities to develop creative partnerships. College students (or even some mature high school students) may be recruited as interns or volunteers. As various programs have shown,13 securing men from the local community to volunteer, though often difficult, is possible. Ultimately, the continuity and effectiveness of a male-focused initiative may depend on whether a point person from the program is prepared to train and coordinate a revolving supply of volunteer help. That help will be critical for some sites because an ample supply of time and energy will be required to entice young men to visit the site and participate in a program. In contrast, a more modest investment in human resources will be needed to help reproductive health professionals and volunteers develop initiatives based on my conceptual framework.
For health educators and family specialists working within a school setting, the infrastructure and resources needed to promote elements of my framework within a classroom environment may be in place already or require minimal investment. The self-narrative approach may need to be modified in classroom settings if too many students feel self-conscious about revealing personal information. An alternative approach that I have used successfully with college students is to have small groups of students create a detailed procreative life story for a hypothetical person. Students are encouraged to then use the analytic framework and concepts I have proposed to examine the ways the imaginary person's procreative consciousness is expressed in response to different hypothetical life events and circumstances. Applying such an approach in instructing high school students is feasible.14
In short, community- and school-based initiatives that draw upon my framework to promote men's self-awareness of their sexual and procreative identities are both timely and practical. The challenge for health care providers and educators is to develop, expand and refine strategies that enable young males to become more aware of their sexuality and more responsible about their power to create human life.