Culture, Medicine, and Psychiatry

, Volume 42, Issue 4, pp 840–861 | Cite as

“If One Does Not Fulfil His Duties, He Must Not Be a Man”: Masculinity, Mental Health and Resilience Amongst Sri Lankan Tamil Refugee Men in Canada

  • William AffleckEmail author
  • Umaharan Thamotharampillai
  • Judy Jeyakumar
  • Rob Whitley
Original Paper


Refugee men face unique mental health stressors in the pre- and post-migratory periods. However, there has been little in-depth research on the mental health of refugee men in Canada. Given this situation, the overall aim of this study is to explore the psycho-social experience of Sri Lankan Tamil refugee men in Canada. Particular objectives include better understanding any inter-relationship between war-trauma, migration, concepts of masculinity and mental health. The study employed a two-phase participatory action research design based on the grounded theory approach. Phase 1 involved an 8-month ethnography conducted in Sri Lanka. Phase 2 consisted of qualitative interviews with 33 Sri Lankan Tamil refugee men living in Canada. Consistent with grounded theory, analysis was conducted inductively and iteratively. Four specific themes emerged from the data (i) gendered helplessness of war: participants commonly reported ongoing negative rumination regarding experiences where they were unable to adequately protect loved ones from physical suffering or death; (ii) reduced capacity: participants frequently felt unable to fulfill culturally sanctioned duties, such as supporting their family, due to ongoing pre- and post-migratory stress; (iii) redundancy: many participants felt that they were useless in Canada, as they could not fulfill typical masculine social roles (e.g. provider) due to factors such as unemployment and underemployment; (iv) intimate criticism: some participants reported that their spouses would often attempt to ‘shame’ them into greater achievement by constantly reminding them of their ‘failures’. Many found this distressing. These various failures culminated in a state that we label “depleted masculinity”, which participants linked to emotional and behavioural problems. Participants reported that they actively tried to rebuild their masculine identity, for example by adopting leadership roles in community organizations, which fostered resiliency. Results suggest a need to review and rebuild masculine identity to support the mental health of refugee men.


Refugee Displaced Refugee men Mental health Psychosocial Sri Lanka 



This study received funding from the Canadian Institute for Health Research (CIHR) Frederick Banting and Charles Best Doctoral Research Award #766578.

Compliance with ethical standards

Conflict of interest

All the authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. Affleck, W., Carmichael, V., & Whitley, R. (2018). Men’s Mental Health: Social Determinants and Implications for Services. The Canadian Journal of Psychiatry. Scholar
  2. Affleck, W., Salvaduri, A., & Sikora, L. (2017). Underrepresentation of Men in Gender Based Humanitarian and Refugee Trauma Research: A Scoping Review. Intervention. CrossRefGoogle Scholar
  3. Amarasingam, A. (2013). A History of Tamil Diaspora Politics in Canada: Organisational Dynamics and Negotiated Order, 1978-2013. Colombo: International Centre for Ethnic Studies.Google Scholar
  4. Beiser, M., Goodwill, A. M., Albanese, P., McShane, K., & Kanthasamy, P. (2015). Predictors of the Integration of Sri Lankan Tamil Refugees in Canada: Pre-migration Adversity, Mental Health, Personal Attributes, and Post-migration Experience. International Journal of Migration, Health and Social Care11(1), 29-44.CrossRefGoogle Scholar
  5. Beiser, M., Simich, L., Pandalangat, N., Nowakowski, M., & Tian, F. (2011). Stresses of passage, balms of resettlement, and posttraumatic stress disorder among Sri Lankan Tamils in Canada. The Canadian Journal of Psychiatry56(6), 333-340.CrossRefGoogle Scholar
  6. Bogic, M., Njoku, A., & Priebe, S. (2015). Long-term mental health of war-refugees: a systematic literature review. BMC international health and human rights15(1), 29.CrossRefGoogle Scholar
  7. Chopra,R., Osella, C. and Osella, F., eds. (2004) South Asian Masculinities: Context of Change, Sites of Continuity. Delhi: Women Unlimited.Google Scholar
  8. Clothey, F. (1978). The Many Faces of Murukan: The History and Meaning of a South Indian God. New Delhi: Munshiram Manoharlal Publishers.Google Scholar
  9. Connell, R. W. (1987). Gender and Power. Cambridge: Polity.Google Scholar
  10. Connell, R. W. (1995). Masculinities. Cambridge: Polity.Google Scholar
  11. Connell, R.W. (2005). Globalization, Imperialism, and Masculinities. In M. Kimmel, J. Hearn, and R.W. Connell, eds., Handbook on Studies of Men and Masculinities. London: Sage.Google Scholar
  12. De Mel, N. (2007). Militarizing Sri Lanka: Popular Culture, Memory and Narrative in the Armed Conflict. New Delhi: Sage Publications India.CrossRefGoogle Scholar
  13. De Mel, N., Peiris, P., & Gomez, S. (2013). Broadening Gender: why Masculinities Matter: Attitudes, Practices and Gender-based Violence in Four Districts in Sri Lanka. Colombo: Care International Sri Lanka.Google Scholar
  14. Dressler, W. W. (2017). Culture and the Individual: Theory and Method of Cultural Consonance. New York: Routledge.CrossRefGoogle Scholar
  15. Dressler, W. W., Balieiro, M. C., Ribeiro, R. P., & Dos Santos, J. E. (2007). Cultural Consonance and Psychological Distress: Examining the Associations in Multiple Cultural Domains. Culture, Medicine and Psychiatry, 31(2), 195-224.CrossRefGoogle Scholar
  16. Dressler, W. W., & Bindon, J. R. (2000). The Health Consequences of Cultural Consonance: Cultural Dimensions of Lifestyle, Social Support, and Arterial Blood Pressure in an African American Community. American Anthropologist, 102(2), 244-260.CrossRefGoogle Scholar
  17. Este D.C. & Tachble, A. (2009). Fatherhood in the Canadian Context: Perceptions and Experiences of Sudanese Refugee Men. Sex Roles, 60, 456-466.CrossRefGoogle Scholar
  18. Fragoso, J. M., & Kashubeck, S. (2000). Machismo, Gender Role Conflict, and Mental Health in Mexican American Men. Psychology of Men & Masculinity, 1(2), 87.CrossRefGoogle Scholar
  19. George, G. (2011). The Canadian Tamil Diaspora and the Politics of Multiculturalism. Identities, 18(5), 459-480.CrossRefGoogle Scholar
  20. Gilbert, P. (2016). Depression: The Evolution of Powerlessness. New York: Routledge.Google Scholar
  21. Glaser, B. G. (1978). Theoretical Sensitivity: Advances in the Methodology of Grounded Theory. New York: Sociology Press.Google Scholar
  22. Glaser B, Strauss A (1967) The Discovery of Grounded Theory. London: Weidenfield & Nicolson, pp. 1-19Google Scholar
  23. Government of Canada 2013 Act, Canadian Multi-Culturalism. Revised Statutes of Canada. (1988, c. 31). Government of Canada’s Justice Laws,
  24. Gross, V. 2008 Reconstructing Tamil Masculinities: Kāvaṭi and Viratam Among Sri Lankan Men in Montréal, Master’s Thesis, McGill University.Google Scholar
  25. Hammack, S. E., Cooper, M. A., & Lezak, K. R. (2012). Overlapping Neurobiology of Learned Helplessness and Conditioned Defeat: Implications for PTSD and Mood Disorders. Neuropharmacology, 62(2), 565-575.CrossRefGoogle Scholar
  26. Hellmann-Rajanayagam, D. (2005). And Heroes Die: Poetry of the Tamil Liberation Movement in Northern Sri Lanka. South Asia: Journal of South Asian Studies28(1), 112-153.CrossRefGoogle Scholar
  27. Hyndman, J., & De Alwis, M. (2003). Beyond Gender: Towards a Feminist Analysis of Humanitarianism and Development in Sri Lanka. Women’s Studies Quarterly, 31(3/4), 212-226.Google Scholar
  28. Jaji, R. (2009). Masculinity on Unstable Ground: Young Refugee Men in Nairobi, Kenya. Journal of Refugee Studies, 22(2), 177-194.CrossRefGoogle Scholar
  29. James, K. (2010). Violence Within Refugee Families: Intersecting Patriarchal Culture and the Refugee Experience. Australian and New Zealand Journal of Family Therapy, 31(3), 275-284.CrossRefGoogle Scholar
  30. Kirmayer, L. J. (2004). The Cultural Diversity of Healing: Meaning, Metaphor and Mechanism. British Medical Bulletin 69(1), 33-48.CrossRefGoogle Scholar
  31. Luhrmann, T.M. (2007). Social Defeat and the Culture of Chronicity: Or, Why Schizophrenia Does so Well Over There and so Badly Here. Culture, Medicine & Psychiatry, 31, 135-172.CrossRefGoogle Scholar
  32. Miller, K. E., & Rasmussen, A. (2017). The Mental Health of Civilians Displaced by Armed Conflict: An Ecological Model of Refugee Distress. Epidemiology and Psychiatric Sciences, 26(2), 129-138.CrossRefGoogle Scholar
  33. Murty, M. (2009). Representing Hindutva: Nation, Religion and Masculinity in Indian Popular Cinema, 1990 to 2003. Popular Communication, 7(4), 267-281.CrossRefGoogle Scholar
  34. Nghe, L. T., Mahalik, J. R., & Lowe, S. M. (2003). Examining Traditional Gender Roles, the Refugee Experience. Journal of Multicultural Counselling and Development31, 245–261.CrossRefGoogle Scholar
  35. O’Neil, J. M. (2008). Summarizing 25 Years of Research on Men’s Gender Role Conflict: New Research Paradigms and Clinical Implications. The Counseling Psychologist, 36(3), 358-445CrossRefGoogle Scholar
  36. O’Neil, J. M., Helms, B. J., Gable, R. K., David, L., & Wrightsman, L. S. (1986). Gender-Role Conflict Scale: College Men’s Fear of Femininity. Sex Roles14(5), 335-350.Google Scholar
  37. Porter, M., & Haslam, N. (2005). Predisplacement and Postdisplacement Factors Associated with Mental Health of Refugees and Internally Displaced Persons: A Meta-analysis. JAMA, 294(5), 602-612.CrossRefGoogle Scholar
  38. Seligman, M. (1975) Helplessness: On Depression, Development and Death. New York: Scribner.Google Scholar
  39. Somasundaram, D. (2010). Collective Trauma in the Vanni-A Qualitative Inquiry into the Mental Health of the Internally Displaced Due to the Civil War in Sri Lanka. International Journal of Mental Health Systems4(1), 22.CrossRefGoogle Scholar
  40. Somasundaram, D. (2014). Scarred Communities: Psychosocial Impact of Man-Made and Natural Disasters on Sri Lankan Society. New Delhi: SAGE Publications India.Google Scholar
  41. Steel, Z., Chey, T., Silove, D., Marnane, C., Bryant, R. A., & Van Ommeren, M. (2009). Association of Torture and Other Potentially Traumatic Events with Mental Health Outcomes Among Populations Exposed to Mass Conflict and Displacement: A Systematic Review and Meta-analysis. JAMA, 302(5), 537-549.CrossRefGoogle Scholar
  42. Strauss, A., and J. Corbin 1998 Qualitative Research: Procedures and Techniques for Developing Grounded Theory.Google Scholar
  43. Thirangagama, S. (2011). In My Mother’s House: Civil War in Sri Lanka. Philadelphia: University of Pennsylvania Press.Google Scholar
  44. Vitlae, A. & Ryde, J. (2016). Promoting Male Refugees’ Mental Health After They Have Been Granted Leave to Remain (Refugee Status). International Journal of Mental Health Promotion, 18(2) 106-125.CrossRefGoogle Scholar
  45. Weerackody, C., and S. Fernando 2011 Mental Health and Well Being: Learning from Communities Affected by Conflict, Dislocation and Natural Disaster.Google Scholar
  46. Whitley, R. (2011). Social Defeat or Social Resistance? Reaction to Fear of Crime and Violence Among People with Severe Mental Illness Living in Urban ‘Recovery Communities’. Culture, Medicine & Psychiatry, 35:519-535.CrossRefGoogle Scholar
  47. Whitley, R., Kirmayer, L. J., & Groleau, D. (2006). Understanding Immigrants’ Reluctance to Use Mental Health Services: A Qualitative Study from Montreal. The Canadian Journal of Psychiatry, 51(4), 205-209.CrossRefGoogle Scholar
  48. Whyte, W. F. E. (1991). Participatory Action Research. Thousand Oaks, CA: Sage Publications, Inc.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Social and Transcultural PsychiatryMcGill UniversityMontréalCanada
  2. 2.Vavuniya General HospitalVavuniyaSri Lanka
  3. 3.Batticaloa Teaching HospitalBatticaloaSri Lanka

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