Friday, 20 July 2018

Editorial Gender and health are also about boys and men

The Lancet Published: 21 July 2018 PlumX Metrics DOI: | Attention to the gendered dimensions of health has tended to focus on improving the disadvantages and vulnerability of girls and women. But to fully understand the ways that gender shapes how people live, work, and optimise health, more awareness is needed about the circumstances of men's lives that adversely affect their health. Men consistently experience shorter lifespans, greater threats to health and safety, and less access to health care than women. Needed insight into gender is revealed in a new report from the American Psychological Association, which highlights the particular vulnerabilities of racial and sexual minority males who do not experience the same power and privilege typically afforded men in the USA. The report, published last month, argues that the systematic oppression experienced by these men has led to higher rates of trauma, substance use, depression, and violence. Boys and men of colour have worse health status but also are more likely to be poor or incarcerated, to have fewer educational and employment opportunities, and higher exposures to crime. Sexual minority men have higher rates of HIV, suicide, and mental health problems, but also more exposure to harassment, hate crime, and stigmatisation. The report's explanations for the disparities are especially instructive. More so than lifestyle causes of risk, the report shows how rigid gender norms make these men vulnerable to poor health. For example, ideas and perceptions of masculinity—control, toughness—drive behaviour such that minority boys and men may suppress emotions when traumatised or hide symptoms of depression. Expectations of machismo lead to increased risk taking. For sexual minority men, their vulnerability to violence could be due to perpetrators' affirmation of hegemonic masculinity. In turn, masculinity norms that expect invincibility limit men's seeking of help and health care. Recommendations include building awareness of the structural determinants of men's health risks and more accessible health care for mental health and trauma. Above all, it reminds us that being gender blind benefits neither men nor women.