Abstract This qualitative study used unstructured interviews to gain insights into how families in the Bugisu sub-region conceptualise masculinity in response to safe medical male circumcision (SMMC), as promoted by the Ugandan government. Results were obtained from cultural leaders, clan leaders, traditional surgeons, medical officers, 2016 initiates, focus groups and the key informant, a representative of Inzu ya Masaaba. Processing the audio recorded responses and data analysis involved transcribing, interpreting, coding, categorising, and generating findings using Atlas Ti software. The results of the study suggest that families in the Bugisu sub-region are ambivalent about the implementation of the safe medical male circumcision policy (SMMCP). Both historical and political attempts to abolish TMC have evoked resistance, with most holding firmly to TMC as the only means by which Bamasaaba boys can acquire the status of manhood. However, some families see health values in medicalised male circumcision practices and believe that medicalisation has caused positive adaptations to TMC for purposes of enhanced hygiene and safety.