The public health scourge that is Machismo

Merriam-Webster defines machismo as:

  • a strong sense of masculine pride an exaggerated masculinity 
  • an exaggerated or exhilarating sense of power or strength

Last weekend, the other practicum students traveled to Copacabana and La Isla del Sol for a little getaway. While there, they did a lot of hiking through Incan ruins. During one such hike, they saw a family with two children – one boy and one girl. Both children were crying because they were tired and struggling on this hike. The parents told the boy to “man up” and “don’t cry, men don’t cry”. Their reaction to their daughter was quite different. Simply put, they ignored her.

This is machismo (or toxic masculinity) in action: teaching boys that expressions of emotion are a weakness and emasculating; teaching girls that their voices don’t matter, that they are incapable of exercising control over themselves, that they are invisible.


Machismo has all sorts of negative societal implications, primarily concerning domestic violence and women’s rights. However, machismo also exerts enormous influence upon women’s health.

The clinics and hospitals in El Alto, a city that is predominantly indigenous, are full of teenage girls who are pregnant, have contracted various STIs, or have developed uterine cancer as a result of HPV. And when I say teenage, I mean young women that are 13-19 years old. (I try not to judge, but I still thought boys were icky when I was 13!)

Many of these women are unaware of the basics of sexual health and their reproductive rights. Because it is so culturally ingrained that a man knows best, they don’t know how to have a conversation about contraception with their partners, and go along with whatever their partner wants. Even worse, it is acceptable for the men to walk away from their responsibilities, because raising children is “women’s work”.


The burden of childcare and/or disease management falls entirely upon the shoulders of these women, and this is where we see how machismo also infects relationships between women.

  • Many of the pregnant teens will tell their doctors that they cannot go back to school after their baby is born, because their mothers won’t let them. This perpetuates a cycle of poverty and misinformation.
  • Many will say their mothers-in-law won’t let them work outside of the home, because their only job is to be a wife and mother. This perpetuates a cycle of financial and emotional dependence.
  • Many husbands and families will deny a pregnant woman permission to obtain a C-section, even when the life of the mother and baby are at risk, because a “real woman” delivers babies vaginally/naturally. This perpetuates a cycle of avoidable maternal and child mortality.

Each case serves as an example of how little little autonomy women have over their own bodies and health choices. Imagine having to get permission from your husband to see the doctor. Imagine having to get permission from your husband to obtain necessary medical tests and life-saving procedures. Imagine having to get permission from your husband and mother-in-law to work, because you’ve been taught that you’re only “real” job is to take care of your husband, children, and household.


Critical public health indicators such as maternal and child mortality and rates of infectious disease will remain high until women are empowered to make their own health decisions. It is not just men that must be educated in gender equality, but women’s attitudes about their roles in society must also change.