Abstract Whilst sexual violence against men in armed conflicts has long been marginalized in research and policy, the recognition that it is far more widespread than previously understood is slowly gaining ground. Based on research carried out in Uganda in 2015, this article explores how a group of male refugee survivors of sexual violence have been able to organize, heal and become activists, and reflects on how we should understand and engage with this struggle. We hear how these men have begun to heal through mutual support and politicized collective action, and how humanitarian organizations and service providers can play crucial roles in support. The authors call for: challenging binary views of gender that permeate much current policy; developing open-ended, survivor-driven psycho-social support models; and supporting refugee male survivors’ activism through action research into advocacy and global networking strategy, to continue destabilizing the silence over male victimization in conflict-related sexual violence. Introduction Men’s experiences as survivors of sexual and gender-based violence (SGBV) remain extremely marginalized in research, policy and practice alike, both in relation to contexts of conflict and in humanitarian responses to forced migration. With gradual growth in academic and policy work on the issue (Oosterhoff et al. 2004; Carpenter 2006; Russell 2007; Sivakumaran 2007; United Nations 2008; Johnson et al. 2010; Solangon and Patel 2012; United Nations 2013; Dolan 2017b; UNHCR 2017; Daigle and Myrttinen 2018; UNHCR 2017), it is only just beginning to enter popular consciousness. Journalists writing on the topic typically write as if they are ‘breaking the silence’—language that presents survivors as victims without a voice (e.g. Storr 2011; BBC 2012). Against this backdrop, however, Men of Hope Refugee Association Uganda (MOHRAU) provides an important counter-example to this disempowering media narrative of silenced, isolated and wholly marginalized male survivors. Drawing on research carried out with MOHRAU in Kampala between May and December 2015, we explore a range of questions arising from this experience: How have male refugees in Uganda been able to organize and become activists who break the silence around male victims of sexual violence? What has been the role of mutual support and collective action? How important are non-governmental organizations (NGOs) and service providers in supporting their work, their resilience and their capacity to organize collectively? We then look critically at what our answers imply for understanding, theorizing and engaging with refugee male survivors of conflict-related sexual violence, for supporting them to heal and to find a voice. The background and methodological approach are followed by key findings on the questions of how members of this refugee group have become able to organize and find a voice in the second section. In the third section, we discuss the findings and consider how best to theorize the issues raised in order to then conclude with implications for research, policy and practice. Background Sexual violence is a recognized feature of many recent and ongoing conflicts in Africa. Its frequent depiction as a ‘weapon of war’ has raised public awareness and some political will to respond. However, the focus has been overwhelmingly on women and girls as victims and survivors, whilst reluctance to giving attention to male survivors appears to be deep (Touquet and Gorris 2016; Dolan 2017b). Resistance appears to be variously grounded in fears over competition for limited funds or the notion that the fight against sexual violence is intrinsically part of a broader fight to overturn a global ‘gender hierarchy’ in which male victims are seen as a contradiction in terms (e.g. Ward 2017). The belief that women and girls are overwhelmingly and disproportionately affected (e.g. Bennice and Resick 2002) is reflected in many international resolutions such as the United Nations Security Council Resolution (UNSCR) 1325 onwards—and this despite a general lack of data on the prevalence of SGBV against men. The World Health Organization notes that official statistics on male victims of rape ‘vastly under-represent’ actual numbers (WHO 2002: 154) and the Special Representative of the UN Secretary General on Sexual Violence in Conflict points out that the difference in ‘levels of conflict-related sexual violence against women and … men is rarely as dramatic as one might expect’ (United Nations 2013: 9). Obstacles to male survivors disclosing are powerful in several ways (Mezey and King 2000). Prevalent norms of masculinity deny male vulnerability, whilst male sexuality is often associated with active penetration and female sexuality with being penetrated. In the regional context, connected beliefs that men cannot be raped support notions such as that any man being penetrated by another must ‘want it’ and thus be homosexual, or perceptions that he is thus feminized (Sivakumaran 2005, 2007; Dolan 2011). Such beliefs are further legitimized and reinforced through laws that define and criminalize involvement in same-sex sexual acts without regard to issues of consent or coercion (Sivakumaran 2007; Daigle and Myrttinen 2018). An absence of services targeting the specific needs of male survivors is a further major disincentive for disclosure by male survivors (Donnelly and Kenyon 1996; Coxell and King 2002; UNHCR 2017). Yet, there has been a gradual growth in recognition of the issue of male victimization through sexual violence in conflict (Appadurai 1998; Taylor 2003; Oosterhoff et al. 2004; Sivakumaran 2005; Carpenter 2006; Russell 2007; Sivakumaran 2007; Johnson et al. 2010; Solangon and Patel 2012; Dewey and St Germain 2013; Touquet and Gorris 2016). Evidence produced by Johnson et al. (2010) suggests significant levels of sexual violence against men in DRC and Sierra Leone, for example. Conducting systematic screening of its refugee clients, the Refugee Law Project (RLP) has found that the percentage of men reporting experience of sexual violence in their lifetime ranges from 25 to 39 per cent, depending on the location of the screening (on arrival, at clinics in refugee settlements or at the organization’s offices), although these figures remain lower than for female refugees and remain unpublished. A survey of 447 male refugees in a camp in Uganda (99 per cent of whom originated from DRC, with a median age of 30 years and 73 per cent of whom were married) revealed that 13.4 per cent reported exposure to sexual violence in the past year, whilst 38.5 per cent reported having experienced sexual violence in their lifetime (Wirtz et al. 2014), consistently with findings from routine screening by RLP. The urgency of responding to such figures is underlined by the continued conflict and violence in the DRC, and they also beg questions for the response to refugees from the region more broadly. The recent, and still ongoing, mass influx of refugees from South Sudan into Northern Uganda has resulted in over a million South Sudanese refugees in Uganda as of December 2017 (GOU and UNHCR n.d.). Recent screening of these arrivals indicate that rates of sexual violence against both female and male refugees is significant, although disclosure appears initially low and to increase after a year of arrival (Dolan 2017a). An earlier survey of male refugees from South Sudan in Uganda found 30.4 per cent to report having ever experienced sexual violence or witnessed such violence against other men (Nagai 2008). As the RLP first began discovering a number of male survivors of sexual violence from around the Great Lakes Region amongst their clients, a workshop was convened for some 150 men in 2009 to discuss their perspectives on sexual violence. This catalysed a gradual increase in disclosures by male survivors approaching RLP. By mid-2011, a small group of three male survivors of sexual violence were meeting at least monthly, with numbers growing to over 40 within a year. MOHRAU, also referred to as ‘Men of Hope’ below, formalized itself in 2012, with the election by the members of a president and an executive committee. The RLP has continued to support MOHRAU by providing meeting space, technical support, South–South exchanges, as well as training and support with media work for advocacy. In collaboration with the Institute of Development Studies (IDS), a film workshop was held with the members, resulting in their producing a short film called The Bench (MOHRAU 2014). This helped MOHRAU and RLP to think about different ways in which issues could be raised. MOHRAU also initiated advocacy activities with local government and delivered community workshops, the latter also leading to some referrals of Ugandan male survivors to the RLP. Whilst maintaining close links with RLP, it is now an independent association, raising funds to support its core costs and seeking to register as a legal entity. Methods The research on which this article draws employed a collaborative and grounded approach, using multiple methods, such as individual interviews, group work, participatory video testimonies and a participatory film production. The framing and questions and methods were co-constructed between IDS and RLP staff together with MOHRAU members. The design aimed for understanding to emerge interactively from generating the questions, data and analysing findings together, as opposed to searching for a range of predicted answers to a predetermined hypothesis, whilst also taking context and history into account in the way that meaning was constructed in the analysis (Varcoe 2006). A context-specific framing was developed between the MOHRAU leadership group, RLP staff and researchers from IDS, through a facilitated dialogue. Following an initial sharing of questions and perspectives on sexual violence against men in conflict, a clustering of key questions and concepts for exploration was carried out in a second meeting. These concepts included: male identity and gender; multiple identities and marginalization; individual and group healing; the role of the group; transitions or transformations; access to services and the roles of providers. This was followed by agreeing aims and main research questions, after which researchers elaborated specific research and interview questions and agreed. These were tailored for different groups of informants, and then modified and agreed with leaders at MOHRAU. Individual interviews were carried out by two or three team members each, matched with participants in terms of language abilities. One researcher led each interview and the other/s transcribed answers and interpreted specific indigenous terms or phrases. Transcripts were cross-checked with interviewer notes and later coded for analysis. Following the individual interviews, one focus group discussion was conducted with members on the issues posed by the emerging analysis; the researchers presented preliminary findings and association members discussed proposed topics in small groups, followed by group feedback and a structured plenary discussion led by the authors. Men of Hope members also led their own process of telling and visually capturing individual and collective narratives. This involved five association members in leadership roles developing their individual video testimonies of their journeys to activism (MOHRAU 2015a), and a broader group of 22 members creating a 30-minute dramatized documentary film entitled Men Can Be Raped Too (MOHRAU 2015b). RLP and IDS staff provided members with technical support in participatory film making. In all, 40 research participants included 36 Men of Hope members and four of their female partners; all were refugees living in Uganda who had escaped conflicts in the Great Lakes Region, predominantly from DRC but also a small number from Burundi and Rwanda. The IDS-RLP research team conducted 13 semi-structured interviews with purposefully sampled individual members of MOHRAU and four with their female partners. The sampling was done by RLP staff and leaders of MOHRAU for developing an understanding both of a range of individual journeys and of the dynamics of the group. Five leaders in the group developed video testimonies addressing the same set of questions from the study. These five later joined five other members, who had been interviewed or taken part in the film production, to take part in the participatory analysis discussion of preliminary findings. Participants in video testimonies were self-selected from the leadership group and participants in the film production were selected by the same leadership group, supported by RLP media staff, on the basis of skills and interest in participation. Ethical standards were agreed between leaders in the association and researchers from RLP and IDS. Informed consent forms, on which the respondent specified their chosen degree of anonymity, were developed and monitored by RLP and IDS. Risks of disclosure were carefully explained and all participants were given the option of anonymity. Most chose fictional names but some insisted on using real names in order to ‘speak out’. In order to balance anonymity with requested attribution, we do not distinguish between real names or pseudonyms in this article, and we only specify anonymity where this option was chosen. In the participatory video work, all participants were mentored on potential risks of public visibility and RLP provided support throughout the process. Consent and release forms were obtained from all who participated. Furthermore, RLP staff with experience in referrals to service providers closely accompanied association members in the work. Ethical clearance was obtained through IDS’s ethics review process and a submission was filed with the Research Secretariat of the President’s Office in Uganda, prior to the in-country research. Certain limitations of methodology should be noted. First, the sampling of participants from association members (and some partners) precluded perspectives from the wider community of refugees or from service providers (other than from RLP). This is mitigated by the range and diversity of participants from the group and the knowledge of RLP researchers. Second, perspectives of RLP and IDS colleagues might have privileged particular points of view. To mitigate this, researchers conducting interviews together checked each other’s interpretations during interviews and transcripts and notes afterwards. Perspectives were also cross-checked throughout the workshop, further analysis and write-up of findings. The participatory visual methods further improves transparency, as it allows viewers and readers to compare the written outputs with the survivor-led video products. Findings So, how have male refugee survivors of conflict-related sexual violence been able to heal, organize and become activists in Uganda? To answer this, we explore, in turn: the personal impacts on refugee men of exposure to sexual violence, their transformations through collective healing, the political dimension to their healing and ‘speaking out’, as well as their own perspectives on the roles of NGOs and other service providers in their struggle. Impacts of Exposure to Sexual Violence on Refugee Men The study did not aim to map or categorize the types of sexual violence experienced, but accounts by survivors interviewed nevertheless captured a diversity of forms. Their descriptions focused on whether the survivor was targeted directly or by association, whether gang-raped or abused by an individual, whether sexually tortured in different ways and/or whether forced to watch the rape of family members. Despite this considerable diversity in forms of sexual violence experienced by participants in the study, descriptions of the impacts of their experiences carried many common traits. These include negative effects on their physical health (including internal injury) and highly debilitating and lasting mental health and psycho-social impacts, and severe blows to their sense of power and self-esteem linked to specific aspects of personal identity, not least to their sense of gender and sexual identity. These impacts were typically marked by an immediate and radical sense of displacement from the self and even from humanity, with feelings of intense stigma and isolation from others. One participant, Steve, explained: ‘When they finished, I felt as if I was no longer myself.’ He later summed up that he no longer felt like a ‘human being’, having lost both his ‘personality and dignity’. An anonymous participant described how, after his rape, he ‘felt like somebody who was in a pit’ unable to escape, adding that ‘people used to say it was … witchcraft’. This felt distancing from a former self and appeal to witchcraft, echoed in several testimonies (sometimes metaphorically), underlines the sense of total deconstruction of their identities described in many of the accounts. Another man, Waka, described how ‘you risk being regarded as someone without value’, giving this as the reason why he ‘hid the story and could not talk about it’. Such accounts of a recourse to self-imposed silence were common and were explained as a response to feelings of excommunication and entering an indeterminate status. The main reason cited for the stigma experienced was linked to the view of male-to-male sexual intercourse as ‘unnatural’ in their communities or in ‘African culture’. In describing this othering from (heterosexual, ‘normal’) male identity, one participant, Jean-Baptist, described being diminished and humiliated and that he had ‘become like a woman, taken the place of a woman’, adding that his feelings of shame and fear made him not want to talk to others. Many expressed incredulity and confusion around their difficulties with now identifying as ‘men’. The former MOHRAU president, Alain, described how ‘it affected how I felt I was a man. … [A]m I a man, or am I no longer a man?’. Chris, another participant, described feeling ‘like a half-man’, whilst many expressed a fear that their troubles call into question their heterosexuality. This sense of destabilization of categories of gender identity commonly linked masculinity to heterosexuality in a conventionally binary way. These challenges with male identification were also linked, for many, to a numbing of their sexual potency. Didier explained: ‘I have lost my identity and … with my wife, the happy moment … when I could satisfy her with the sexual relationship.’ Another man, Amani, described how ‘it has affected me a lot, because erection was a big problem’ and the female partner (anonymized) of another male survivor corroborated the severity of the issue, explaining that ‘[the] biggest problem is [our] sexual life, and because—as a woman—… he can’t satisfy me’. Male sexual potency appears here as a marker both of a man’s power and agency in relational terms, and of his self-esteem and identity as a man. These debilitating impacts were perceived by respondents to have affected broader social and economic dimensions to their identity and wellbeing. These included challenges in terms of fatherhood and family provision, difficulties in taking on manual labour (due to internal injuries sustained) and additional barriers such as xenophobia and homophobia restricting their access to work in Uganda. Their personal challenges with gender and sexual identity, as emasculated men, intersected with discrimination experienced on the basis of their ethnic and refugee status to multiply their sense of exclusion and precariousness in this context. Various descriptions of the indeterminacy of the men’s subjective status suggested a strong sense of being in a liminal space, outside or in between recognized and normative states of being. Personal Transformations Through Collective Healing and Action Peer support has been crucial in these men’s processes of healing: to rebuild hope, recognition, belonging and healing. Jean-Baptist described how the journey started for many with being ‘victims just seeking assistance’. He described how they were encouraged and helped through counselling and how ‘there was a healing process’ that led them to start thinking through ‘how to help others, how to break the silence, how to bring others with similar problems [to] come together and be assisted’. In his video testimony, activist Thierry explains how ‘belonging in a group is a form of healing’. The group helps survivors to break out of their sense of isolation, both by creating an awareness of how their own problems are similar to those of others and by generating a sense of belonging. In his video testimony, Aimé described how his learning with the group had made him realize that the silence was ‘causing a lot of harm; it was eating up many things in my body’. One participant, Tito, explained that ‘[w]hen you are many, you realise that others have undergone the same experience’ and Steve described how ‘the shame has been taken away’ and how he now feels ‘liberated’. These perspectives emphasize how, while suffering begins as intensely personal, healing is highly relational; it happens in interaction with others with similar concerns, rather than as an individual process. Personal benefits of being in the group include sharing knowledge of support services, giving and receiving direct practical assistance, drawing inspiration from others’ approaches to healing and accessing trainings. The support also extends beyond the group itself. A female partner, Antho, described how, when they are having problems at home, group members sometimes ‘intervene and provide guidance and advice’. There are thus many reasons for members to stay with the group, both for personal benefit and for that of others. In his video testimony, activist Steven explains how ‘if I waked up and also assist one more person, [to] save life; that was my motivation’. In the collective, there is space for an iterative development of individual self-expression and mutual learning, as group members go through a process of reconstructing personal identity and ‘co-writing’ their collective history. The group process simultaneously enables journeys of healing and of becoming new men through the group itself developing over time. The emerging pattern of the men’s accounts spoke more to joint efforts at ‘transformation’ of their lives and identities than to the idea of simple ‘transitions’ between distinct states. In these journeys of transformation in identities, there was often a sense of movement from ‘victim’ to ‘survivor’ and often to ‘activist’. There was no consistent view of any linear progression, however, and some saw themselves as fitting all three identities, often illustrated by accounts of flashbacks and a notion that their experiences have marked many for life. The identity of ‘survivor’ was seen variously as positive or problematic. Tito argued that if ‘you … call me a survivor, it diminishes … the experiences’. David felt that, whilst ‘I still have the identity as a victim ..., I believe to become a survivor—it is in the process of healing’. Perhaps ‘healer’ may have been a more appropriate term than ‘survivor’, since their accounts quickly moved on to their deep need for connection and mutual healing, but also to a desire to reach out to help others and to ‘break the silence’, which we turn to next. The Will to Speak Out and Mutual Healing as a Political Choice In Steven’s video testimony, he describes how, after his victimization as a result of rape, being ‘a survivor … was the struggle within to getting healed…’, but that he would now ‘feel freer to be called a human rights activist’. In another of the five video testimonies, Joseph describes how, when he first heard others talk openly about their challenges in a safe space, it ‘was a wonderful experience’. When prompted about their motivations for activism, he explained: ‘our biggest motivation is that we know that our fight is a good fight, because we are fighting injustice … our purpose is so clear.’ Testimonies and interviews suggested that building a shared consciousness of the violence of their experience was seen as motivating and empowering. Their process has built a critical consciousness amongst members that they have a stake in addressing sexual violence and that they want to hold certain institutions to account. One focus group discussion participant argued that they: need to influence the policies makers [and] law makers, because most of the time different organisations are ready to assist females who were raped, but there is almost none which cares for men and boys. Francine, the female partner of another participant, explained that if he can talk to the local councillors and help them to understand, then they can also tell the hospitals that this is something that has happened and their work can be better. Another participant, Okoko, acknowledged that this might not always be easy when he described how ‘the local council chairman … could not give us assistance because he did not understand’. This incomprehension was explained by what was commonly referred to as ‘the confusion’: a common conflation between men having been raped and their being thought of as homosexual, which is also fuelled by the penal code failing to recognize that same-sex sexual acts may be coerced. MOHRAU’s aspirations for influence stretch from local and national to global levels, recognizing that significant change would require the transformation of not only local-level channels for accountability, but also of national and international regulatory frameworks and commitments. Jean-Baptist openly speaks about his experience of sexual violence ‘at the local and international level, so that … it would be possible to get solutions to … victims, but also to stop or reduce the problem’. He adds that organizations and the ‘international community … should know what is taking place and what armies and armed groups are doing, so that people can be helped’. Despite the deeply traumatic, personal character of group members’ experiences and the lack of response to their plight in the broader city, they aim to make claims for the rights of all male survivors of sexual violence on a footing of equal rights to visibility and assistance. It is not that the group underestimates the injustices faced by female survivors of sexual violence, but they insist on a sense of justice based on equal human rights for all. Refugees’ Perspectives on the Role of NGOs and Service Providers The roles of NGOs and service providers are varied, from connecting members to different kinds of support, to nurturing the groups own development and to leveraging their voices for a broader and deeper influence. The range of outside organizations is potentially both broad and complementary. In his video testimony, Steven describes how ‘[t]he RLP sends us to hospitals… InterAid can offer us counselling … UNHCR can offer support for the family … HIAS can offer like education’. He then goes on to describe how ‘[t]he partners assist you to gather you back, to bring you back to step forward’. Referrals are not seen as enough on their own, but a deeper engagement with partner institutions is seen as also needed. Participants described how RLP has played a key role in training medical professionals to improve their service provision. MOHRAU members described how they have also sensitized other organizations, as explained by Amani: ‘Before then, they were not aware that we exist and they did not know our problems.’ One activist also underlined the importance of NGOs being aware of their own power in their relations with refugees. Increased access through diverse partnerships can play important roles in mobilizing resources for activities, like community sensitization. It was also explained that certain partnerships have even facilitated engagement with perhaps more reluctant stakeholders, such as local officials or religious organizations. Most of the participants underlined the crucial importance to Men of Hope of having developed in very close partnership with RLP, including through their facilitated ‘coming together’ under the latter, offering both a sense of a ‘home’ to group members and a protective constitutional/legal umbrella. Important ingredients to this were said to include: open forms of communication, enabling trust and accountability, be it in personal interactions or the organization’s professional response; and recognizing male survivors as being at the centre of the solutions. Examples of the positive results of this support have included creating space for working with female partners or when a group discussion on homosexuality during the research led to a request for a follow-on training on sexuality (and this being provided) to help members navigate the conceptual and legal confusions on the topic. Thus, it was clear that the citizenship and activism of the group cannot be seen in isolation, but that they are nested and supported by a network of external engagements and actors. The group now aims at extending their influence through engaging in both advocacy and research nationally and internationally. One member, Steve, emphasized the importance of extending their reach globally, describing his ‘wish that the voice of men and boys grows and reaches out to the world’. Alain identified journalists as crucial partners for giving voice to activists, since ‘they can reach where we aren’t able to reach … they are another … voice supporting us to move forward’. This is not purely about influencing policy makers directly, but also about reaching out for a broader mobilization amongst some of the most excluded. As Aimé explains, ‘it allows us to reach the world of refugees and prisoners’. Discussion What, then, are the key implications for how we should understand, theorize and respond to male refugee survivors of conflict-related sexual violence? What might it mean for research, policy and practice? Understanding the Impact of Sexual Violence Against Men in Conflict Settings We did not set out to analyse the drivers, nature or meanings of perpetrating sexual violence in conflict, as such. Yet, the wide range of forms of sexual denigration and victimization disclosed by male survivors, coupled with the many similarities in their experiences of the impacts, suggest that some explanations are called for. Stereotypical narratives of sexual violence as gender-based violence against women fall short here, so we clearly need a more considered approach. In a wide-ranging comparative exploration of globalization and extreme ethnic violence against men and women, Arjun Appadurai (1998) theorized bodily violence within closely related groups—especially diverse forms of sexual violence—as akin to ‘vivisection’ or a type of ‘bodily deconstruction’ for resolving unmanageable levels of uncertainty about identity or ‘belonging’. He described these high levels of suspicion as resulting from a distortion ‘of national and local spaces of everyday life by the physical and moral pressures of globalization’ (ibid.: 905). Beyond the apparent intention to exert power, humiliate and inflict pain, he points to ‘a horrible effort to expose, penetrate and occupy the material form—the body—of the ethnic other’ and that this ‘may well be the key to the many ways in which sexuality is implicated in recent forms of global ethnic violence’ (ibid.: 917). This account is useful in that it resonates with our male survivors’ experiences of the impacts of exposure to such violence: the deconstruction of their sense of self, the common appeal to witchcraft (which Appadurai discussed in relation to research from Cameroon) and their sense of devastating loss of identity. Whilst the targeting of the violence experienced by participants in our study seemed to be more about ethnic identity and group affiliation than gender, it also involved a deployment of sexualized power, gendered masculine and, through this, a reversal or destruction of the victims’ own gender identity. To understand the ‘gender-based’ element of this violence, we need to understand how men’s own attachments to an essentialist understanding of their sex and masculinity—their ‘male identification’ as necessarily and ‘naturally’ heterosexual—get assaulted and manipulated for their own subjective deconstruction, within traditionally patriarchal settings. Alan Johnson argued that any given society ‘is patriarchal to the degree that it promotes male privilege by being male dominated, male identified and male centred’ (1997: 5). Whilst male privilege, centeredness and domination are familiar structural concepts in gender theory, male identification is perhaps less often analysed, but is particularly relevant to subjective identification within any context. Male identification was central to Simone de Beauvoir’s (1949) account of gender construction—for women as well as men—and fundamental to her understanding of the marginalization of women as ‘Other’. Building on her work, French feminist writers (e.g. Cixous and Clément 1986) drew on Jacques Derrida’s (1987) idea of ‘logocentrism’—that positive–negative binary opposition is core to how reference works in Western language—and used his term ‘phallogocentrism’ to describe how a privileging of the male (phallic) defines women in relation to it—and by what they lack, namely negatively. Other writers have pointed out how this idea of positive–negative juxtaposition has shaped gender narratives and how other binary oppositions themselves become gendered by repeated association, such as vulnerability, victimization or being penetrated as gendered feminine set against violence, perpetration or penetration as gendered masculine (e.g. Butler 1990; Connell 2003). These juxtapositions shape not only gender narratives and identification, but also policy frameworks and practice on gender and violence in development and humanitarian fields (Edström 2014; Myrttinen et al. 2014), which we address further down. The idea of phallogocentric male identification, and the way in which male victims experience this as being undermined and reversed, thus helps us to understand the depth of the existential threat posed to refugee men victimized through sexual violence. The fact that perpetrators and victims alike have internalized attachments to this binary becomes central to the perpetrators’ strategic deployment of sexual violence, knowing that it will throw the victims into a space of existential confusion and self-doubt. As Chris described, he was left feeling like ‘a half-man’, whilst Jean-Baptiste felt he had ‘become like a woman’ and Steve no longer felt like a ‘human being’. Intersectionality and the Structural Violence of Refugee Male Survivors’ Life in Exile So, how can victimized and disempowered refugee male survivors heal and become agents of change, in the context of the many challenges of their new country? As Appadurai reminds us, the experience of victimization is not only about gender. The same can be said about the ability of refugees to rebuild their lives in exile. In understanding the dynamic between male refugee survivors’ subjective identification and their new contexts, it may be helpful to draw on the concept of ‘intersectionality’ to explore their own complex multiple identities, the structural constraints of their context and how personal change can take place within this space. In its basic form, we can understand intersectionality both in terms of multiple intersecting social identities and as intersections of related hierarchies of privilege and oppression based on gender, ethnicity, sexuality and social class, for example (Nash 2008). Choo and Marx Ferree (2010) distinguish further between three ways of understanding the concept: as group-centred, focusing on overlapping identities; as process-centred, seeing multiple forms of discriminations as driving oppressive processes; and as system-centred, understanding intersectional dynamics to be co-shaping entire systems. This may be particularly relevant for understanding the complexities of Men of Hope in relation to identification as well as processes of exclusion, assistance and healing, within the complex context of Kampala. In relation to their own identities, we need to unpick the specific situation of male refugee survivors of sexual violence in a highly chaotic and liminal space of exile. The very fact of migration can itself shift people’s perceptions of gender norms and identifications, including men’s sense of their own masculinity (Donaldson 2009), as also documented for men fleeing violent conflicts in the Great Lakes Region (Jaji 2009). This is compounded by the impacts on men of victimization through sexual violence specifically, as their masculinity and sexuality are called into question, which further complicates their subaltern identities as foreign, refugees, poor, etc. In Uganda, major contextual—or structural—transformations have over the last century been shaped variously by colonialism, independence and militarized power struggles, neo-colonial intrusions (in trade and aid) and shifting applications of religion in politics and community life (Dolan 2011; Wilhelm-Solomon 2013). These histories can shed light on current highly oppressive and hegemonic patriarchal ideals for men, which reject vulnerability as well as social or cultural difference within a highly religious, nationalistic, militarized and heterosexist setting (Coughtry 2011; Cheney 2012; White 2013). In terms of processes of ‘change’ for these men, the idea of ‘transitions’ may initially present itself as a likely concept for understanding these questions. However, we found it more useful to frame these dynamics as ‘transformations’ and to draw on Victor Turner’s (1977) anthropological concept of ‘liminality’, which he initially used to refer to traditional African rites of passage. This notion has been applied in different contexts and levels, including to historical moments where major transformation can result from significant crises (Horvath 2013), and indeed also to the complex ways in which Congolese refugees in Kampala construct new notions of home and belonging (den Boer 2015). We found it useful to explore the ways in which—as suggested by Turner (1977) and others (Jaji 2009; den Boer 2015)—liminal states of confusion and chaos also carry the potential for creativity and building agency, from the dissolution of old meanings and connected social restrictions, through their transformation into new meanings and integration with a new sense of identity. However, this notion of ‘integration’ can mean into the same community or into another community (as in refugee assimilation, for example) or it may involve the formation of entirely new communities with new relationships, identifications and value systems. How, then, do refugee male survivors of sexual violence in Kampala get from the trauma, chaos and marginalization in their lives to healing and positive action for change? Psycho-Social Healing by Survivors as a Response for Change A common approach to the needs of victims of sexual violence is to focus on individuals’ trauma and pathological conditions to get them back to a former state of wellbeing—to individual recovery. A psycho-social view of trauma and recovery, by contrast, considers social wellbeing and relational functionality alongside, and in interaction with, personal wellbeing (Joseph and Linley 2008) or as personal psychological recovery being linked to supportive social contexts and peer support (Mead et al. 2001). The psycho-social approach has been applied in a wide range of settings—from HIV treatment to responding to trauma and supporting recovery following conflict—by agencies like Médecins Sans Frontières (De Jong and Kleber 2007). The facilitated establishment and nurturing of the MOHRAU peer-support group has created a safe space for male survivors, empowering them to take an active role in responding to their own plight. As one activist in our study, Thierry, explained, ‘belonging in a group is a form of healing’. Mutual support seems to enable simultaneous group and individual healing. It also involves challenging the sources of their marginalization, where a collective questioning of traditional patriarchal norms of male supremacy and invulnerability also helps to break their isolation: their healing is intrinsically political, and their activism profoundly therapeutic. Our findings above suggest that positive psycho-social perspectives on peer support can be highly effective for working on trauma with groups of refugee male survivors of sexual violence. While this type of framework often casts healing as a journey from vulnerability and trauma to coping, recovery and onto reintegration (ibid.), we should be wary of simply seeking to re-establish pre-existing social networks, norms and functionality that underpinned the effectiveness of sexual violence in the first place. Instead, we should recognize that peer support, coupled with the right kind of external inputs, can potentially lead to a more open-ended (re)building of agency and new identities, communities and norms. These may well prove more gender-equitable than those from which the victims were excised. The fact that such new and less patriarchal identities may struggle to find acceptance and integration within Ugandan communities and institutions poses a serious challenge. Related to this, many of the refugee male survivors we met expressed ambivalence towards the host country and hoped for resettlement in a third country, as do many refugees in the broader diaspora (den Boer 2015). Nurturing Therapeutic Activism for Empowerment Our research points to the importance of exploring and understanding the liminal and fluid spaces that members of such groups tend to inhabit and experience, as well as how their peer support can empower them to co-construct new identities and to ‘speak out’. Indebted to feminist scholarship, we understand ‘empowerment’ as a process of enabling better access to resources, conscious and deliberate individual and collective action, and effective choices, all realized as well as constrained in interaction with structural inequalities and power dynamics (Kabeer 1999). Building on Paulo Freire’s views on empowerment through critical consciousness and collective action, Naila Kabeer (2005) argues that marginalized groups can also build new identities through their strategies for recognition, claims for inclusion and the very processes of group formation. Refugees typically leave behind social status, entitlements and networks (Clarke 2009), to take on a new ‘status’ typically managed by host-country governments and service providers, including humanitarian agencies. These usually focus on basic needs of broad categories of people based on standardized assessments of ‘vulnerability’ that fail to account for intersecting identities and oppressions, and that ignore refugees’ potential for agency, creativity and freedom. This atomizing governmentality for managing refugees does little to help them rebuild a social identity or articulate a collective voice, and instead prioritizes the political interests and bureaucratic expediencies of donors and humanitarian agencies (Trad and Kagan 2008). We have seen that refugee male survivors of sexual violence can become politicized through the process of their own healing, and of healing others. This does not conform to notions of passive victims who merely need assistance. Indeed, it suggests that those responding to refugee survivors of sexual violence—whether male or female—must also, in addition to direct support, pay attention to their spaces and means for citizenship. Reconceiving Citizenship to Open Spaces for Recognition and Voice The complex context of the Great Lakes Region is one of violent conflicts, fragile governance, semi-permeable borders and mobility. This, coupled with the fact that citizen action can take variously visible or hidden forms within open, invited or claimed spaces, and across levels from the local to the global (Gaventa 2006), suggests that traditional Westphalian notions of citizenship centred on the nation state need to be extended to incorporate other levels and spaces for civic participation. Steven Robins and colleagues (2008) suggest exploring citizenship through the entry point of everyday practices and experiences in specific local historical contexts, essentially rethinking citizenship through the eyes of people themselves, informed by the ‘politics of everyday life’ (ibid.: 1069). These conceptual extensions enable us to begin to link our analysis of male survivors’ daily activism with the supportive roles of other stakeholders, as well as with the group’s ambitions for global activism. MOHRAU offers refugee male survivors of sexual violence a micro-level space for performing citizenship, as well as allowing them to reach out to their broader refugee and host communities and other local institutions. This challenges familiar state- (and/or institution-) centric ways of researching citizenship, both because nation states are not the only loci of governance for accountability and claims, but also because individuals, communities and identities cross borders, spaces and levels—from the local to the global (Gaventa 2006), physically and virtually. As we heard from Aimé above, their activism is not only about influencing powerful actors, which they certainly do, but also working to ‘reach the worlds of refugees and prisoners’ more globally. The Claim for Global Citizenship and Mobilization Smyth and colleagues (2010: 413) note a growing interest in connections between refugee integration and transnationalism, and the role of transnational networks. Our research found strong orientations amongst the men involved to reach out and advocate for their issues both locally and internationally. Despite contextual and historical differences, some lessons from the global response to HIV may prove useful. Vinh-Kim Nguyen’s (2007) characterization of peer-support groups of HIV-positive people in Africa during the 1990s, as gradually moving from a therapeutic ‘bio-sociality’ to a politicized ‘therapeutic citizenship’, pointed to such claims and processes being partially enabled through strategic connections to northern-based HIV activist networks. We describe the direction and process of the members of MOHRAU as ‘therapeutic activism’: they unite around a shared need for therapy, their healing becomes political and drives their activism and the activism itself has therapeutic benefits. Whilst united under a strategic identity of ‘survivor’, members of Men of Hope comingle diverse combinations of gender-based violence, xenophobia, homophobia and patriarchal oppression. Can we perhaps see the beginnings of parallels here with the global mobilization around HIV, which, under the unifying theme of the ‘greater involvement of people living with HIV’ (UNAIDS 2007), also linked other diverse identity-based civil society movements, such as for sexual rights, women’s rights and sex workers’ rights, from local to global levels (Altman 2001; Edström 2010). Although these coalesced around responding to the challenge of a particular virus, they were also united by shared experiences of marginalization, stigma and discrimination, as well as a commitment to equal human rights for all. What type of intersectional alliances might then be most relevant for male survivors of conflict-related sexual violence? Examples might include: sexual violence survivor platforms, other networks against SGBV, refugee rights groups, sexual rights movements, networks of organizations engaging men and boys for gender equality, child rights networks and peace movements, including women’s peace movements. Thus, lessons from HIV-positive groups entering the ‘bio-politics’ of the global response to HIV may be relevant for how survivors of sexual violence are supported to make claims in the gender, humanitarian aid and law fields globally, even if the sectors and associated resources differ significantly. Beyond Essentialist Gender Binaries and Stereotypes in Sexual Violence There is one overriding fundamental implication from our study, whether for governments and other institutions responding to refugee survivors, for those elaborating policy frameworks or for those mobilizing research and funding: the phallogocentric binary construction of gender must be roundly rejected and discarded from policy and practice claiming to promote equality, human rights and gender justice. Vulnerability and agency are both real and significant, and they coexist—often in the same subject—and must therefore be separated from any essentialized ideas on gender binaries or gender hierarchies. If the international community concerned with refugee issues has begun to recognize this issue to some extent, there is still some way to go. Institutional and epistemological resistance remains deeply entrenched in the international architecture related to policy in gender and development as well as in peace and security. For example, the recent Sustainable Development Goals, despite aiming to ‘leave no one behind’, fail to recognize male survivors of sexual violence in their targeting of SGBV (referred to as ‘violence against women and girls’) and in their efforts to eliminate ‘all harmful practices’ under Goal 5 on gender equality. Goal 16 on promoting peaceful and inclusive societies claims to target ‘reducing all forms of violence’ (emphasis added). Yet, in choosing as an indicator the ‘proportion of young women and men aged 18–29 years who experienced sexual violence by age 18’ (emphasis added), it again excludes those forms of violence experienced by adult men. At the level of global refugee and related policy domains, whilst recognizing that even impressive policy statements have limited chances of impact unless implemented forcefully at local levels (Milner 2014: 485), it is important to note that there has been some progress. The declaration of the G8 on 11 April 2013 reflected a shift by clearly stating that Ministers underlined the importance of responding to the needs of men and boys who are victims of sexual violence in armed conflict, as well as to the needs of those secondarily traumatized (FCO 2013: 2). A subsequent UN Security Council Resolution, UNSCR 2106, was the first such resolution to mention men and boys as victims of sexual violence, in June 2013. The shift towards recognition of the issue continued into both the policy on gender crimes of the International Criminal Court (ICC 2014: 30) and in the Global Summit on Ending Sexual Violence in Conflict, held in London, in June 2014. Furthermore, certain recent training provided through CERAH, Justice Rapid Response (under UN Women), MSF and UNHCR has also reflected some inclusion of the issue (e.g. United Nations 2013). Yet, these small victories in recognition for male survivors of sexual violence remain all but invisible in the supposedly inclusive Sustainable Development Goals. The struggle to unpick the gender-binary straightjacket tying up global asylum systems thus continues. Researchers can document, engage and critique, but change may more likely come from practitioners and activists in places such as Kampala—if these can be supported to access a global audience. Conclusion It is indeed possible and urgent to support and nurture the healing of survivors of sexual violence through facilitating their peer support and collective action, for male as much as for female survivors. Models of trauma recovery need to be broadened, from individual healing towards collective healing, and with appropriate mixes of therapeutic models enabling a collective building of new identities and new relationships, whilst challenging discriminatory norms on gender, ethnicity and sexuality. The key implication for policy and practice in humanitarian responses to sexual violence in refugee contexts is that we must discard the familiar gender-binary models for meeting needs of individual women or households. Instead, we should aim to accommodate and work with diverse support groups, elaborated around and adaptable to different—and evolving—identities and community formations, to support their healing and activism, from local to global levels. There are a number of implications for work with and by development aid agencies. Policy frameworks and legislative changes need to increasingly take an approach to gender and violence that is inclusive of men and women and to emphasize how gendered relationships construct gender identity. This needs to be complemented with policies and investments enabling processes of global citizen engagement that support survivors of sexual violence to influence international frameworks (as was done in the global HIV response). Future research and analysis of conflict-related sexual violence need to include the issue of sexual violence against men, and increased funding is urgently required to strengthen prevention and response for all survivors. Civil society actors and humanitarian agencies need to examine deeply their own policies, screening methods and service protocols to determine how inclusive and empowering of male survivors they are, or how they may in fact be exclusionary and discriminatory. Development of stronger training methods is needed to support humanitarian agencies and services for more inclusive approaches. Where refugee-led support groups do not exist, civil society actors can support and mentor their establishment and the strengthening of their capacities. Implications for researchers are also challenging and diverse. Combining perspectives across disciplines of anthropology, social psychology, citizenship, power analysis and participation is encouraging; more support for inter-disciplinary research is called for. In terms of operations research to improve existing services, we advise adapting psycho-social models for group healing to move away from simple rehabilitation and reintegration towards open-ended and participant-driven approaches. Participatory action research with diverse groups of refugee survivors of sexual violence could open up new learning and the development of new approaches, locally and internationally. The fact that, despite their marginalization, refugee male survivors of sexual violence are keen and able to take active roles in shaping and conducting such research may be relevant for refugee studies more broadly. Acknowledgements This research was partially funded by the United Kingdom Department for International Development (DFID) under an Accountable Grant to the Institute of Development Studies (IDS), 2011–16. It was also supported by grants from the Swedish Research Council and the Riksbankens Jubileumsfond. The authors would like to extend particular thanks to our colleagues Thea Shahrokh and Onen David, who were closely involved in shaping the research. Many other individuals at the Refugee Law Project (RLP), IDS and MOHRAU also provided invaluable support. The authors would like to thank all members of MOHRAU involved for their proactive engagement in the research process, particularly Aimé Moninga, Alain Kabenga, Thierry Inongi, Steven Kighoma and Joseph. 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Journal of Refugee Studies – Oxford University Press
Published: Jun 2, 2018
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