This chapter is about how manhood is transposed in assemblages of masculinity. This transposition implies that old gender sentiments become actualized in a new context with very different outcomes. Expectations about behavior change in public health initiatives and discourse, including gender-transformative approaches, are commonly based on assumptions about an individual’s ability to make free choices. In contrast, the qualitative case histories from urban South Africa presented in this chapter show how change depends on affect in social relationships. The men in this study overcame affective health problems through mutuality, reciprocity, and what I call relational dignity. The African notion of ubuntu holds that dignity results from actions that lead to recognition from human and nonhuman others, and which create a sense of personhood and belonging. The young men recovered from substance use and psychosis, stopped committing violence, and overcame their suicidality based on open reciprocity or forms of exchange through which care for the self and care for the ‘other’ were mutually constitutive. Relational dignity nevertheless put them in a tenuous position.