How Masculinity Is Killing Men

In a new study titled, "Masculinity in the doctor's office: Masculinity, gendered doctor preference and doctor–patient communication," published in Preventative Medicine, Mary Himmelstein and Diana Sanchez set out to find out why men have shorter life expectancies and are more likely to suffer from several leading causes of death. Expanding on scientific literature that links toughness and avoidance of weakness with negative implications for health, among other traits associated with male norms, Himmelstein and Sanchez found that men who adhere to the traditional scripts of masculinity and hold the belief that manhood is precarious—or that it could be "lost"—were more likely to choose a male doctor over a female doctor due to implicit bias. In turn, men who consulted with a male doctor were less likely to have open and honest conversations about their medical health, which is an integral step in early detection and preventative care. In other words, men who "tough out" minor health problems because they believe that going to the doctor is a sign of weakness are, in part, killing themselves.

"In my research I find that upholding gender ideals, for men and women, is very restrictive," Sanchez told Broadly over the phone. "There's been a lot of work as of late talking about how masculinity has a lot of negative effects, so we were interested to see if masculinity played a role in men's willingness to engage in preventative care and how they disclose their symptoms to doctors."

For the first part of the study, the researchers recruited 250 men to answer a set of questions related to their ideas about masculinity and manhood. The same participants also answered questionnaires about the importance of having a male doctor and gendered medical competence. Though men did not explicitly believe that male medical professionals were more competent than women, respondents who scored highest on the masculinity scale were still more likely to prefer a male to a female doctor.

"Men preferring a male doctor over a female doctor only matters if choice of a male doctor somehow influences doctor–patient communication," the researchers write. So they conducted a third test to see if men actually do underreport their symptoms to male doctors; Himmelstein and Sanchez recruited 250 men from around campus and divided them into two random groups. One group would discuss their health with a female interviewer wearing a white lab coat. The other would talk with a male interviewer, also wearing a white lab coat. Participants were told that the interviewers were students enrolled in pre-medicine who were interested in gaining clinical experience. All participants were asked to take the masculinity test and were also asked about five common, chronic health problems before their appointment as a control.

"We found that when men actually interacted with male doctors, they were inhibited or less accurate in reporting their health symptoms," Sanchez said. "The men who talked to the male pre-med students were less likely to disclose their physical health symptoms accurately if they scored high on the masculinity test."

Himmelstein and Sanchez conducted a separate study in 2014 that illustrated how gender beliefs contribute to men's healthcare avoidance. That study "showed that men who scored high on the same masculinity questionnaire were less likely to engage in preventative care and more likely to delay going to the doctor." Together, the two studies show masculinity's negative effects on health, Sanchez said. "One could say that masculinity potentially plays a role in men's higher mortality than women," she said.

Thus, Sanchez explained, one way for men to take better care of their health could include rebranding doctor visits. "We're looking into ways that we can make men think of seeking medical help as a masculine act," she said. "We're trying to think of ways to intervene for men who think that masculinity is at odds with healthcare."

Of course, another way would be to dispel gender myths altogether, though that's a harder task. "We've had years of men endorsing masculinity," Sanchez said. "Because it may be so difficult to get men to not endorse this masculinity idea, we might need to start with reshaping how they think about healthcare."