Month: July 2021

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The extradition of Italian ex-terrorists in France puts an end to the Mitterrand Doctrine

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Giulia de Nardin

International Relations and Global Governance Analyst

The extradition of Italian ex-terrorists in France puts an end to the Mitterrand Doctrine

Thanks to the operation ‘Red Shadows’ (from Italian: ‘Ombre Rosse’), France released on probation all former Red Brigades terrorists apprehended in its territory and wanted by the Italian justice after several years of contentious and protracted negotiations. 

The law will now require them to comply with several obligations, such as signing and reporting to the police twice a week in Italy, as long as they wait for their trial. The French attempt to tackle this judicial and political issue counters the famous and much-debated Mitterrand Doctrine by reopening the dossier after decades of controversies. The reasons why the Macron government has taken up the case are far from being accidental. Whether this decision is because France has been deeply transformed by terrorist attacks, because of the understanding between the current Italian and French political leadership, or simply to allow President Macron to win the upcoming elections, it takes place in a particular geopolitical climate worth analysing.

The first person to announce the news to the press was Jean-Louis Chalanset, the French lawyer of the ex-militant of the Red Brigades, Enzo Calvitti. Calvitti is now aged 66 and will have to serve a sentence of about 19 years’ detention, in addition to probation for four years. Raffaele Ventura, ex-terrorist belonging to the ‘Autonomia Operaia’ group, was sentenced to approximately 24 years for the murder of Deputy Brigadier Antonio Custra on 14 May 1977 in Milan during a demonstration organised by the extra-parliamentary left. His lawyer affirmed that he was in a legitimate situation in France, according to what was agreed when he arrived in the country back in 1982: in order to be considered as out of clandestinity, he submitted to regular police controls and abandoned all criminal activity in both countries¹. He also obtained French nationality, but these actions were not enough to convince Italy to waive his extradition^1. Calvitti and Ventura are not the only ones who will have to face this legal procedure. The former militants affected by this new order and their respective political parties or organisations to which they belonged are: Giorgio Pietrostefani of ‘Lotta Continua’; Roberta Cappelli, Marina Petrella, Maurizio Di Marzio, Sergio Tornaghi, Enzo Calvitti and Giovanni Alimonti of ‘Red Brigades’; Narciso Manenti of ‘Nuclei Armati’; Luca Bergamin of ‘Proletari Armati’; Raffaele Ventura of ‘Autonomia Operaia’².

This case traces its origins back to the so-called ‘Years of Leads’ (from Italian: ‘Anni di Piombo’),  thus named because of the high number of shootings that occurred in Italy from the late 1960s to the late 1980s, and the above-mentioned former militants participated directly or indirectly in one or more crimes during this period. The fact that they could stay in France to avoid serving their respective sentences in Italy, thus gave rise to the so-called ‘Mitterrand Doctrine’.

The socio-political scenario back then was characterised by social conflicts and political tension, as well as a number of acts of terrorism carried out by right and left-wing political and student organisations. This period started in a tense political climate, marked by the so-called ‘Hot Autumn’ strikes in 1969. In the following months, there was an escalation of terrorist attacks with the killing of policeman Andrea Annarumma during a public protest organised by the Italian Communist Party (PCI), the Piazza Fontana bombing on 12 December 1969 provoked by the extreme right and the subsequent death of anarchist Giuseppe Spinelli, wrongly accused of the massacre and who died in uncertain circumstances in police custody³. Many other incidents such as the Borghese Coup (1970), the ‘Piazza della Loggia’ bombing in Brescia (1974), the White Coup (1974), the Italicus train bombing (1974), the Bologna massacre (1980) stained this era with blood; but its ultimate climax was the kidnapping and assassination, orchestrated by the Red Brigades, of Christian Democrat secretary and former prime minister Aldo Moro (1978). With his left-leaning view, he was implementing a deal called the ‘Historic Compromise’, trying to include the PCI headed by Enrico Berlinguer in the Italian government, but his plan was abandoned after his death.

Many militants accused of taking part in these terrorist acts fled to countries that granted them protection thanks to their asylum policies: most of them went to France, while others opted for South American countries such as Brazil and Nicaragua. The French Socialist President at the time, François Mitterand (1916-1996), elaborated a policy, presented for the first time during a speech at the Palais des Sports in Rennes on February 1st 1985, that refused to accord extradition of Italian citizen involved in the Years of Lead violent acts, exept in case of “active, actual, bloody terrorism”⁴. He then affirmed at the 65th Congress of the Human Rights League, on 21 April 1985, that “Italian refugees (…) who took part in terrorist action before 1981 (…) have broken links with the infernal machine in which they participated, have begun a second phase of their lives, have integrated into French society (…) I told the Italian government that they were safe from any sanction by the means of extradition”⁵.

The raison d’être of the Mitterand Doctrine is controversial. According to an article published in 2007 by the Italian newspaper ‘Il Corriere della Sera’, it was the French Catholic priest Abbé Pierre who persuaded Mitterrand to pursue this policy⁶, while according to the lawyers of the former militant Cesare Battisti, he took this decision following consultations with Bettino Craxi, the then Italian Socialist PM. Analysing Mitterrand’s policy in more depth, ever since he was Minister of Justice in the Guy Mollet government during the Algerian war, he had declared himself opposed to emergency and exception laws, considered political violence legitimate in certain cases and prioritised human rights issues: this makes his position in the fight against terrorism consistent over time⁷. The Mitterrand doctrine has never been defined or embodied in any law.

Decades after the events, the extradition of ten former terrorists definitively marks the end of the Mitterrand doctrine. Despite the fact that the policy had already been ‘violated’ in 2002 with the extradition of Paolo Perisichetti, ex-member of the Red Brigades, and that the French Council of State had declared it of no legal value, France continued to deny the extradition of numerous ex-militants during the years. Other releases followed, without France ever accepting the Italian requests in their entirety, often due to problems with the Italian criminal investigation: France could not accept its legal conclusions because the accusations often came from a so-called ‘pentito’ (a former criminal who later repented), a figure not recognised by the French legal system⁸. For this reason, it is worth noting that it never happened until April 2021 that France granted extradition for such a large number of former terrorists, thus marking a turning point in diplomatic relations between France and Italy concerning asylum policies and  in the dismissal of the Mitterrand Doctrine. Many ex-terrorists are still missing from the roll call to be extradited to Italy to serve their sentences, and we expect France to be cooperative after setting a precedent like this.

There are several reasons, although not all yet confirmed by official sources, that justify the choice of French President Emmanuel Macron to grant extradition during the spring of 2021 and explain why the doctrine has come to a standstill. In particular, we recognise the impact that recent terrorist attacks had on France’s new security policies. We also acknowledge the positive influence of the relationship between French President Emmanuel Macron and Prime Minister Mario Draghi on diplomatic relations between France and Italy and the importance of President Macron’s current political choices on the upcoming presidential elections. First of all, Italy was trembling because of terrorism  in the ‘Years of Lead’, and France has found itself in a similar though not entirely comparable situation, with the attacks that have plagued it in recent years. As stated by the Elysée “France, itself affected by terrorism, understands the victims’ absolute need for justice. Through this handover, it is also consistent with the imperative need to build a Justice Europe, in which mutual trust must be at the centre”. 

Among the many attacks, we will mention the Charlie Hebdo shooting (7 January 2015), the Paris attacks (13 November 2015), the Nice truck attack (14 July 2016), the Normandy church attack (26 July 2016), the Champs-Élysées attack (April 2017), the Marseille attack (1 October 2017), the Strasbourg attack (11 December 2018) and the two extreme right-wing attacks on mosques in Brest and Bayonne (27 June and 28 October 2019). These tragic incidents did not leave France impassive: following the Paris attacks, President François Hollande proclaimed the state of emergency (from French: état d’urgence) in November 2015, which was then replaced when President Emmanuel Macron introduced the 1510 Act to reinforce internal security (30 November 2017). Given that the Mitterrand doctrine opposed Italian anti-terrorism laws in some regards, it cannot be ruled out that the French decision to bury this policy was taken with the precise aim of removing obstacles to possible future diplomatic cooperation concerning terrorism. For example, if in the future there will be French terrorists seeking political asylum in Italy, France can hope for greater cooperation from its neighbour country if it proves willing to give in Italian ex-terrorists today.

Secondly, it cannot be denied that this successful bilateral operation would not have happened without good diplomatic and political relations between France and Italy. In this regard, we must remember how much the relationship between the two states had soured back in 2018-2019: main tensions concerned not only the extradition of Cesare Battisti in 2019, but also the issue of high-speed trains on the border between the two countries, Di Maio’s visit to the yellow vests in France and several immigration incidents.

This led France to recall its ambassador in Rome, and Italy did the same with its one in Paris, and it is worth noting that the previous time an ambassador was recalled it was in 1940 and Italy had just declared war on France.

After these tensions with the then deputy PM Salvini and Di Maio, the Mattarella-Conte-Macron relationship healed in February 2020¹⁰. Later, it improved with the arrival in government of former European Central Bank President Mario Draghi on 13 February 2021, and also with a number of diplomatic and political developments in Libya on which the two have been cooperating¹¹. The reconciliation has also been confirmed by Italian President Sergio Mattarella’s state visit to President Macron in Paris between 5 and 6 July 2021.Last but not least, it should be added that the extradition of the Italian ex-terrorists to France is a judicial but also very political decision. In fact, in less than a year’s time, the current French President Emmanuel Macron will run for the presidential elections,which is why every current political choice he makes may be decisive sfor his re-election. He chose to keep a firm position on the fight against crime and terrorism, as well as on national security issues: in particular, he introduced the 1510 Act to reinforce internal security after the recent terrorist attacks, as mentioned above. Therefore, being inconsistent between domestic and foreign policy would not work in his favour at all if he is willing to be re-elected. Furthermore, the Macron government has always had a pro-European stance, and has in particular supported the creation of a common European legal space. The union of EU states against the threat of terrorism is undoubtedly a fundamental pillar to strengthen future European law on this topic.

[1] La Repubblica (2021), Secoli d’Italia (2021), L’Eco di Bergamo (2021), Le Monde (2021)

[2] RaiNews (2021)

[3] Indro Montanelli, Mario Cervi, L’Italia degli Anni di Piombo (1991)

[4] François Mitterrand, Speech at the Palais des Sports in Rennes (1st February 1985)

[5] François Mitterrand, Speech at the  65th Congress of the Human Rights League (LDH) (21 April 1985)

[6] Massimo Nava, Il Corriere della Sera, Abbé Pierre, il frate ribelle che scelse gli emarginati (23 January  2007)

[7]Marco Gervasoni, Claude Sophie Mazéas, La gauche italienne, les socialistes français et les origines de la doctrine (2010)

[8] Nino Maiorino, Ulisse Online (2021)

[9] French Presidency announcement (28 April 2021)

[10] Conchita Sannino, La Repubblica, Dossier Anni di Piombo: la Francia ora riapre al rimpatrio di 11 terroristi  (11 April 2021)

[11]  Jean-Pierre Darnis, Université Côte d’Azur and Istituto affari internazionali, Se Macron guarda con interesse a Draghi (2021); Maria Grazia Rutigliano, Luiss University, Telefonata tra Draghi e Macron: due leader europei sempre più vicini (22 April 2021)

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Israeli-Palestinian Conflict: The Thorn in the Side of the European Common Policy

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Felipe Taylor Murta

International Relations and Global Governance Analyst

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Israeli-Palestinian Conflict: The Thorn in the Side of the European Common Policy

In the first half of 2021, the Israeli-Palestinian conflict started a new escalation that lasted 11 days before the ceasefire but resulting in a large number of civilian casualties mainly in Gaza and the West Bank.

The post-Oslo era seems to have hardened the coordination of political actors in the promotion of the international agenda, which was aggravated by the decisions made by former American President Donald Trump, and the inability of the European Union to jointly promote the main values that constitute the European Neighborhood Policy.

The ceasefire came not long after the international appeal by the UN Secretary General, the current US president Joe Biden and 26 of 27 European Union member states, with the knowingly exception of Hungary. Even though Hungary was the only country to fully support Israel, one of its most important partners, other EU members have blocked political action of the block for many years as a result of geopolitical interests.

This analysis seeks to understand the position of the European Union stances, considering its official statements and the difficulties behind the negotiation amongst its Member States. In order to set a critical analysis for the matter, the first part of this article will focus on historical facts that constitute not only the relations between the EU and Israel and Palestine, but also the constitution of its Neighborhood Policy since the Barcelona process, which is important for this specific conflict. Secondly, it will explore the response of the block to the most recent escalation, which shall result in the final and global analysis.

The European interest in the Middle East is not new, whether considering economic, political, and military variables. Because of the geographical proximity, security and stability became recurrent words in the European discourse towards the region. Since 1995, during the Barcelona process that gave birth to the Euro-Mediterranean Partnership (EMP, 1995-2004), 15 European countries expanded their relations with 13 neighbor countries in the Mediterranean, as for Algeria, Cyprus, Lebanon, Malta, Morocco, Syria, Tunisia, Turkey, Israel, and Palestine. The cooperation amongst member-States called for good governance, the rule of law, human rights and partnerships in economy, finance, politics, and culture.

Under the EMP, Association Agreements were made, including the continuation of ‘preferential’ arrangements with Israel, that were first introduced in 1975, and resulted in growing trade relations with the country, as well as the increasing participation in the peace process. Concomitantly, in 1997, an Interim Association Agreement on Trade and Cooperation was signed with the Palestinian. Aiming to increase the effort to consolidate peace between Israel and Palestine, the EU has acted in building security, especially in the Palestinian Territory (PT), initiating with the Joint EU-Palestinian Security Committee, that sought to improve the security sector in the PT, and creating an institutional infrastructure that would take responsible a Prime Minister and Interior Minister for the counter-terrorism efforts.

During that period, tensions were not resolved. Between 2000 and 2002, the second intifada led to an increase of attacks carried out by Palestinian forces against Israel, resulting in military responses that brought all PNA infrastructure to the ground. The many attempts to build a sustainable peace in the Middle East has its roots in both differences between EU Member States’ geopolitical interests and in the comprehension of which path should be taken in order to establish stability. Let us start with the latter.

The European Union Foreign Policy, considering both the ENP and UfM (former EMP) understand that in order to achieve peace, democracy and good governance are essential.

Discussing this first point needs to address the definition of both subjects. Good Governance, according to UN Officials, shall show eight main characteristics: it is participatory, representative and accountable, consensus-oriented, transparent, responsive to societal needs, effective and efficient, equitable and inclusive, and follows the rule of law; which would ensure that minorities be heard in the decision-making process. Nevertheless, the idea of interaction between society and the state is not the same, including how they understand democracy.

Democracy has many ways to be defined, and according to the concept, its link to good governance can become weaker or grow stronger, while full democracy can also only exist with good governance. The problem resides in the structure called ‘democratic piety’, borrowing the term from Adrian Little, where democracy is considered to be a cure for violent conflict, a belief rooted in the democratic peace theory. Furthermore, only considering the electoral practice, and minimizing or even ignoring other political realities as a consideration in the resolution of a conflict is erroneous.

In the case of the Israeli-Palestinian conflict, focusing only in creating a mirrored institutional frame that reflects western – thus European – values, their ideas of good governance and democracy, is quite complicated. First, it assumes that the same model would be accepted in different cultures and perspectives and reflects rather the own European interest in maintaining stability in its neighborhood, rather than establishing sustainable peace in different terms. Thus,

Analyzing only the recent escalation between Israel and Palestine shows that the response from the European Union differs considerably from its latter statements, which would often be more neutral. The last statements communicated by Peter Stano and Elisa Castillo Nieto, respectively Lead Spokesperson for Foreign Affairs and Security Policy and Press Officer for Foreign Affairs and Security Policy at the European Union, condemn Hamas’s rockets as a clear attack to Israeli people, whilst recognizing the legitimacy of Israel’s response in protecting civilians. National actors from the block assume similar political positions. For instance, Australian Chancellor Sebastian Kurz has decided to fly the Israeli flag in public buildings as a form of public support in the conflict. In Germany, the left and right wings in political class have shared their support for Israel, reinforced by former Chancellor Angela Markel statement, where Hamas’s actions are considered as “terrorist attacks’ ‘.

Those are not the only two European countries to establish a pro-Israeli political behavior. Israeli prime Minister, Benjamin Netanyahu has recently thanked France, British, German, and Austrian presidents for their support, and, evidently, the United States. The foreign policy shift could be explained by recent proximity between Israeli Head of State and illiberal European Leaders, such as Hungarian Prime Minister Viktor Orban and Italian Deputy Prime Minister Matteo Salvini.

The European Union remains the biggest financial actor of the U.N Relief and Works for Palestine and they maintain their official position calling for a peace process and end of occupation, with a two-state solution since 1967 (except for Hungary and Czech Republic). However, the Israeli-Palestinian situation has been put aside considering the importance that other Middle East situations have acquired. During the 2000s, most of European Leaders and negotiations as a block considered that resolving the Israeli-Palestinian situation would solve Middle East problems. However, Arab Spring and Iran nuclear movements have shifted priorities, and some European diplomats privately acknowledge the Abraham accords. In addition to it, Israeli economic importance in R&D in security and innovation put the country in a position as one of the main contributors in terms of security for the European Union. Recently, Athens and Jerusalem announced a $1,65 billion defense contract. The countries’ tech performance brought the country close to Europeans too: Israel was the first non-European country to be associated with the EU scientific body, CERN. Shall we not forget that France, since 2011, has purchased 500-million-dollar worth of Heron drones from the country, braking with the 44-year embargo proclaimed by Charles de Gaulle, followed by Emanuel Macron’s economy and digital affairs minister in the Israeli innovation Festival back in 2017, just after the election. Germany followed the path, engaging in a 9-year contract for Israeli drones, in a 1.2 billion contract, that would be further used to European Security. In 2020, Airbus and two Israeli air and space companies were called up together to launch drones over the Mediterranean Sea to monitor migrant smuggler ships.

Thus, the position of the European Union is rather complicated. It is important to take other steps in order to aid the peace process in the region, different from the Oslo agreement.

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Last dictatorship in Europe — what should the EU do with it?

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Maksim Vassin

International Relations and Global Governance Analyst

Last dictatorship in Europe — what should the EU do with it?

On May 23rd, 2021, in violation of numerous international laws and regulations, Belarusian Air Force forced Ryanair Flight 4978 to land in Minsk Airport, citing a bomb threat from Hamas.

The threat was quickly discredited as fake, and the plane was given a green light to leave Minsk. However, several passengers stayed behind. Among them was Roman Protasevich, a prominent dissident journalist, and his girlfriend, as well as several passengers who are alleged to be Russian and Belarusian KGB agents. Protasevich and his girlfriend were detained, causing outrage among the EU member states and other countries around the world. The incident was allegedly staged by the Belarusian officials only to detain the journalist. The incident with the Ryanair plane did not start the confrontation between Belarusian ruling regime and its citizens but it became the second act of the conflict stemming from summer 2020, when the sitting president Lukashenka allegedly rigged the election, and the popular winner Svetlana Tikhanovskaya was forced to flee to Lithuania. The largest protests in Belarusian history followed, yet they were brutally suppressed by the oppressive regime, jailing innocent people, silencing the media and doubling down on human rights violations.

Belarus became the battleground for spheres of influence between the Western democratic states and Russia. Belarus sits firmly within Russian area of regional hegemony and its sphere of interests (capitalised on economic and socio-cultural interests in the near abroad rather than outright political manipulation in neighbouring countries) (Szostek, 2018; Trenin, 2009). Russia attempted to integrate it culturally, economically, and socially, especially through the establishment of the Union State between Russia and Belarus. However, on the other side, the Baltic states, notably Lithuania, have tried to influence and accelerate the democratisation of Belarus in 2020. Lithuania gave political asylum to many Belarusian political migrants, pressured the EU to impose new sanctions and, recently, gave Tikhanovskaya’s team diplomatic recognition. On July 5th, Lithuania recognised Tikhanovskaya as the winner of Belarusian elections and gave diplomatic recognition to the Belarusian Democracy Representation Office (source); Tikhanovskaya was recognised as the legitimate winner of the election by Lithuania back in September 2020 (source).

Such interest from the Lithuanian side towards the faith of Belarusian democracy is not surprising nor unjustified, and the answer to this lies within the constructivist international relations theory and recent history of the Baltic states. The relations between states, according to Wendt, are based upon prior interactions and shared historical experiences (Wendt, 1992). The understanding of “common destiny” through historical experiences is important for current foreign and security policy of the Baltic states, and is a uniting component for Estonia, Latvia and Lithuania (Vaiksnoras, 2000/2002). As countries with the highest democracy ratings in the post-USSR space (Economist Intelligence Unit, 2020), it is no surprise that the Baltics, led by Lithuania, are at the front of the line to aid the Belarusian democratic movement gain traction globally and regionally.

However, this is met by many challenges from Russia, as Belarus is seen as an important economic and strategic bargaining tool. Firstly, Russia-friendly Belarus brings a crucial strategic military advantage for the Kremlin — the Suwalki Gap. The Suwalki Gap is a narrow strip of Polish-Lithuanian border situated between the Russian exclave of Kaliningrad Oblast and Belarus. Should military conflict ever ensue and if Belarus stays loyal to the Kremlin, the Suwalki Gap can be closed in a matter of days and would completely cut off the Baltic States from the rest of Europe. The gap is a crucial strategic advantage for Russian forces and is a major weakness in NATO’s defence plan for the Baltic States. Should Belarus democratise and turn towards the EU, this strategic advantage can be lost for Russia, especially since it has invested large sums of money in ramping up its military presence in Kaliningrad.

What should also be noted is the economic importance of Belarus for Russia. The investigation by the journalists of NEXTA, the media outlet spearheaded by the jailed journalist Roman Protasevich, has shown that Russia utilises Belarus as the transit stop to legitimise importing sanctioned EU goods. This has proved to be a major economic boost for both Belarusian and Russian power elite, rather than being an accelerator for the economy that would benefit all (NEXTA, 2021). Again, democratisation of Belarus threatens to undermine such supply chains for both countries and cost the power elite a major source of enrichment.

What should be EU’s next steps regarding the Belarusian democracy crisis?  The most imminent and urgent matter is the refugee crisis on the Lithuanian border. Due to Belarusian state agencies aiding migrants reach Lithuanian border, the Baltic country is facing a refugee influx that it is not capable to deal with. Recent deployment of emergency forces by Frontex (EU Border and Coast Guard Agency) is the first step towards dealing with the matter on hand. However, this only treats the symptoms, rather than the disease. Other Baltic States, Poland, and other countries that have undergone the same transition from a totalitarian dictatorship to a democracy in Europe must give Svetlana Tikhanovskaya diplomatic recognition. Not only it will show unity within the EU but, most importantly, delegitimise Lukashenka’s regime. This will be instrumental in dismantling the system that the governing elite profits off of and boosting the transition process, as well as pressuring EU to impose further sanctions on Belarus.

Are such interventions justified? Locke gives a particularly relevant insight into when interventions in state’s sovereignty are justified. Locke’s natural law sets three basic principles: “no one ought to harm another in his right, health, liberty and possession; inalienable right for self-preservation; not in competition with self-preservation, do everything to preserve others, all mankind”. Should a state violate these laws, others have the right to punish those who deviated from them (Locke, 2015). (Locke also says that they have the right to kill those who violate the laws but, in this context, it is rather extreme). With the regime’s handling of the initial protests in 2020 — reports of abuse, beatings, and even torture — Lukashenka has clearly violated the social contract and laws of nature, thus giving other states justification in meddling with Belarusian internal affairs. The task for the EU is to devise a coherent action plan that would make use of this justification and fast-track the democratisation process in Belarus, while keeping Russian strategic and economic interests in the region in check.

Economist Intelligence Unit (2020). Democracy Index 2020. In Sickness and in Health?

Locke, J. (2015). The second treatise of civil government. Broadview Press.

NEXTA (director). (2021). Лукашенко. Золотое дно (from Russian: Lukashenka. The Golden Bottom).

Szostek, J. (2018). The Mass Media and Russia’s “Sphere of Interests”: Mechanisms of Regional Hegemony in Belarus and Ukraine. Geopolitics, 23(2), 307-329.

Trenin, D. (2009). Russia’s spheres of interest, not influence. The Washington Quarterly, 32(4), 3-22.

Vaiksnoras, V. (2002). The Role of Baltic Defence Cooperation for the Security of Estonia, Latvia and Lithuania.

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The Gender Gap in Men: Social Perceptions and its Effect on the Physical and Mental Health of Men

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Eric Cui Wu

Health & Social Affairs Analyst

The Gender Gap in Men: Social Perceptions and its Effect on the Physical and Mental Health of Men

Equality to access does not mean equality in outcome. That is something that we can profoundly see through the healthcare system. In the European Union, men and women theoretically have the same access to the medical system. Therefore, they should have the same quality of care and outcome when controlling for socioeconomic differences.

Nevertheless, the average life expectancy for men in the European Union is 5.5 years less than women.¹ If we were to ask the public why men have shorter life expectancies compared to women, chances are the most common explanation is that men are more likely to partake in riskier behaviours. While it is true that in general, men are more likely to drink, smoke, have unhealthier diets, and participate in violent actions; all of which affect one’s chances of mortality; it does not fully explain all the differences we see in the healthcare outcome of men and women.² ⁻ ³. There must be some underlining reasoning behind why 75% of all alcohol-related deaths occur in men.⁴ We need to begin to uncover other possible reasons behind why men are more likely to act a certain way and how that affects their relationship with their health.

Going back for generations, cultural expectations of gender roles have continued to shape and dictate the behaviour of men and women. These traditional gender roles still influence our media and culture in the modern era, especially with the rise of hypersexualised social media. Men are told from a very young age to conform to certain ideals of power and strength. These definitions of masculinity are often very strongly tied culturally to one’s own identity and can play a large part in how society perceives their self-worth as a man.⁵ Men are often told not to show emotion and instead be strong, stand up, and fight for themselves continuously… To be a man. This idea that men are unemotional is widespread in media, even with a song from The Cure called “Boys Don’t Cry”. When we tell men to be emotionless, to behave a certain way, we are really setting up some men for failure to not achieve this idealistic masculinity set up by social and political expectations.⁶ False normalities plague the modern media, setting continuously unrealistic expectations of what a normal man’s life is.

Society dictates how a man acts, thinks, looks and responds to the community. This constant pressure can help to explain why men are more likely to take up risky behaviours, as they need a release from societies expectations. However, the impact of these social perceptions does not stop there. How can we expect men to work through their vulnerabilities and behaviours while chastising them for speaking out about their emotions? Ultimately, current societal expectations of masculinity and men detriments men’s physical and mental health; and can help explain some of the reasoning behind why men behave in a certain way.

As we delve deeper into the reasoning behind the gender gap, we can see the effect that the societal ideal of masculinity has on sickness in men’s physical health.

On average, men between the ages of 16 and 60 are less likely to consult a healthcare provider than their female counterparts.⁷ This delay in the timing in which men are unlikely to seek treatment can increase their severe injury and illness risk. In the long run, this reluctance leads to preventable diseases, such as melanomas, where men are 50% more likely to die than women.⁸ This increase in preventable diseases also leads to a general rise in deaths in men, ultimately contributing to the 86% of all male deaths attributed to non-communicable diseases and injuries.⁹ Men are disproportionately affected simply because of the hesitation to seek out help. This hesitation stems from societal perceptions we tell men to power through and toughen up instead of asking for help when they medically require it. These social perceptions of the right way masculine men should act ultimately cause a detriment to the level of preventative care that men partake.

This perception of male strength trickles down to how men intake and interact with medical information. Men are less likely to consult advice from media and their peers and are more likely to pretend that their physical health is normal. Furthermore, because men often dominate the medical field, they are less likely to create and disseminate men’s sexual health information to other men as well.⁸ Men are also generally less likely to seek out medical information independently, despite the multitude of available sources.¹⁰ There are many different layers of complexity to publicising medical advice to men, but underlining it is the perception of masculinity and the strong, independent man. This narrative that seeking help is unmasculine has dampened the willingness of men to receive proper medical guidance. This unwillingness eventually cycles back into men’s health, negatively impacting their physical health in the long term.

An essential counterpart to the physical health of men is the mental impact that perceptions of masculinity can have. Like women, men can and commonly do have body confidence issues and suffer from mental illness. One in five adult males in the UK surveyed has negative perceptions of their body image, with one in having been diagnosed with at least one mental illness.¹¹ The idolisation of unattainable and often unhealthy perceptions of health and the human body in modern media has continued¹² to contribute to the increasing negative self-perceptions of men. As media and companies focus on body positivity in women, there is a marked need for increased attention and men’s inclusivity and body positivity.

Internationally across the board, more men die from suicide than females, often at drastically higher rates.¹³ Nearly every three in four suicide victims in the European Union are male.¹⁴ Many factors can contribute to the higher suicide rate in men, including that men are more likely to commit suicide using deadlier methods. However, one such crucial underlining factor is the unwillingness of many men to discuss their mental health with friends, family and health professionals.⁸ Many societies push their men to be strong and to bottle up their emotions. In a survey conducted by Generation Maastricht of its male volunteers, there was a strong indication across the board that men are less comfortable talking about their mental health to family, friends and medical professionals when compared to their physical health. There is a disproportionate number of men using mental health services compared to women.¹⁵ We say to young children; boys do not cry; men are not supposed to be vulnerable. Be strong and get through it. However, society still wonders why men are less likely to discuss their feelings and more likely to be dependent on alcohol and drugs than women.

Today, it is generally more accepted in many societies if we choose to break away from traditional gender normalities. Expressing your identity, personality and sexuality in ways that do not traditionally conform to preconceived gender roles has been liberating for many. Yet, we still have lingering ideals of masculinity, especially hypermasculinity, which affect many men, cis-gendered and transgender, within the LGBTQIA+ community. It is essential to consider that sexuality is just as important as gender and sex when considering comfort in discussing men’s health. Many LGBTQIA+ men can struggle with openly discussing their sexuality with health professionals. One in five LGBTQIA+ individuals, rising to 40% in bisexual men, are not out to their health professional. One in seven have avoided treatment for fear of discrimination.¹⁶ It may be tough to gauge the openness of health professionals when speaking to them; as such, some may feel compelled to hide what is considered crucial medical information when considering the risks for certain diseases.

A lack of openness among all men in discussing sexuality in society also negatively affects the mental health of LBGTQIA+ men, with one in two LGBTQIA+ individuals currently diagnosed with a mental illness and nearly half of individuals identifying as transgender having contemplated suicide before.¹⁶ Many of these individuals can feel isolated due to traditional normalities of what men should act like, often putting on a mask and hiding from society. Gay men are three times more likely to have depression when compared to the general population and are at a much higher risk for suicide.¹⁷ With 2.9% of adult males openly identifying as gay or bisexual, and a steady rise in the LGBTQIA+ population, it is increasingly essential to consider the needs of queer and transgender men in the picture when we consider men’s physical and mental health.¹⁸ By opening the conversation to include not only heterosexual, cisgender men, we can benefit from the increased shared acceptance and understanding of different expressions of men and masculinity, creating a more welcome environment for all men.

Writing this as a cisgender male, I realise that many of these problems we face in society are so engrained that simply knowing and recognising them does not do enough. Even though I know men should be reaching out for help, I still feel uncomfortable discussing physical and mental health issues. I recognise I have been more likely to dismiss smaller sickness and physical ailments, to the point where they may be affecting my overall physical health. Still, I continue to choose to simply power through it because it feels more comfortable. These gender normalities that have been drilled in my psyche since youth are so ingrained that it takes a lot of work and effort to push against and combat them. And that’s part of the problem; reversing generations of thought and ideas takes an insurmountable amount of time and effort and is a continuous uphill battle. But it is a battle that we must continue to fight for generations to come.

In the end, many other factors ultimately affect men’s healthcare outcomes as well, but this does not mean that we cannot begin to change the narrative. As modern society continues to tackle many traditional societal normalities, the growth in openness to discuss men’s health must continue. Young boys need to be taught to be open with their feelings. Men should feel comfortable discussing their physical and mental health and not feel shamed into silence and self-loathing. The conversation around masculinity and the role of men should change to be more open and accepting of different perspectives. There needs to be continued efforts to improve gender equality in healthcare for both men and women.¹⁹ This improvement also means including women, minorities and LGBTQIA+ individuals in the conversation about men’s health and making sure that men feel comfortable reaching out for help. In the end, healthcare needs to have both equal access and equitable outcome. The methods in which we derive that equitable outcome has yet to be developed. And maybe, one day, the gender gap will simply be a page in the history books.

[1] Eurostat (2021) Mortality and life expectancy statistics [Online]. Available at: https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Mortality_and_life_expectancy_statistics#:~:text=Life%20expectancy%20at%20birth%20in,year%20higher%20than%20in%202018 (Accessed: 21 July 2021).

[2] Pinkhasov, R.M., Wong, J., Kashanian, J., Lee, M., Samadi, et al. (2010) Are men shortchanged on health? Perspective on health care utilization and health risk behavior in men and women in the United States, International Journal of Clinical Practice, 64(4), pp. 475-87.

[3] Harvard Health Publishing (2019) Mars vs. Venus: The gender gap in health [Online]. Available at: https://www.health.harvard.edu/newsletter_article/mars-vs-venus-the-gender-gap-in-health (Accessed: 21 July 2021).

[4] WHO (2018) Alcohol [Online]. Available at: https://www.who.int/news-room/fact-sheets/detail/alcohol (Accessed: 21 July 2021).

[5] Slater, M. (2019) ‘The Problem With a Fight Against Toxic Masculinity’, The Atlantic, 27 Feb. Available at: https://www.theatlantic.com/health/archive/2019/02/toxic-masculinity-history/583411/ (Accessed: 21 July 2021).

[6] Schumacher, H. (2019) ‘Why more men that women die by suicide’, BBC, 18 March. Available at: https://www.bbc.com/future/article/20190313-why-more-men-kill-themselves-than-women (Accessed: 21 July 2021).

[7] Wang, Y., Hunt, K., Nazareth, I., et al (2013) ‘Do men consult less than women? An analysis of routinely collected UK general practice data’ British Medical Journal Open 2013, doi: 10.1136/bmjopen-2013-003320.

[8] Banks, I. (2001) ‘No man’s land: men, illness, and the NHS’, British Medical Journal, 323(7320), pp. 1058–1060. doi: 10.1136/bmj.323.7320.1058.

[9] WHO (2018) Men’s health and well-being in the WHO European Region [Online]. Available at: https://www.euro.who.int/en/health-topics/health-determinants/gender/mens-health (Accessed: 21 July 2021).

[10] Wellstead, P. (2011) ‘Information behaviour of Australian men experiencing stressful life events: the role of social networks and confidants’, 16(2), paper 474. Available at: http://informationr.net/ir/16-2/paper474.html (Accessed: 21 July 2021).

[11] Mental Health Foundation. (2021). ‘Millions of men in the UK affected by body image issues – Mental Health Foundation survey’, Mental Health Foundation, Available at: https://www.mentalhealth.org.uk/news/millions-men-uk-affected-body-image-issues-mental-health-foundation-survey (Accessed: 21 July 2021).

[12] Mental Health Foundation. (2021). ‘Mental health statistics: men and women’, Mental Health Foundation, Available at: https://www.mentalhealth.org.uk/statistics/mental-health-statistics-men-and-women (Accessed: 21 July 2021).

[13] WHO Mental Health and Substance Use. (2021) Suicide worldwide in 2019. World Health Organization.

[14] Łyszczarz, B. (2021) ‘Production losses attributable to suicide deaths in European Union’, BMC Public Health 21, 950. doi: 10.1186/s12889-021-11010-5.

[15] Chatmon, B.N. (2020) ‘Males and Mental Health Stigma’, American Journal of Men’s Health, 14(4), doi: 10.1177/1557988320949322.

[16] Mental Health Foundation. (2021). ‘Mental health statistics: LGBTIQ+ people’, Mental Health Foundation, Available at: https://www.mentalhealth.org.uk/statistics/mental-health-statistics-lgbtiq-people (Accessed: 21 July 2021).

[17] Lee. C. Oliffe, J.L., Kelly, M.T., et al. (2017) ‘Depression and Suicidality in Gay Men: Implications for Health Care Providers’, American Journal of Men’s Health, 11(4), pp. 910-919. doi: 10.1177/1557988316685492.

[18] Office for National Statistics. (2021) Sexual orientation, UK: 2019. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/sexuality/bulletins/sexualidentityuk/2017 (Accessed: 21 July 2021).

[19] WHO Regional Office for Europe. (2018) Strategy on the health and well-being of men in the WHO European Region. World Health Organization.