“It was clear from the accounts provided that there was a widespread reluctance to seek help (or to be seen to be seeking help) as such behaviour was seen as challenging to conventional notions of masculinity. This was particularly evident amongst the younger participants who adhered to a model of masculinity that men who had experienced serious illness had been forced to question. The younger ‘healthy’ participants appeared to have a lot invested in concurring with their peers’ views about what it was to be a man. It was rare for men in these contexts to critically examine these views and how they interfere with help seeking, unless this met with their group’s collective representation of masculine identity. It was apparent that to many participants to (be seen to) endure pain and to be “strong and silent” about ‘trivial’ symptoms, and especially about mental health or emotional problems, was a key practice of masculinity. Many healthy participants thus were eager to embrace a dominant culture of men’s slowness and reluctance to consult and to emphasise their lack of health service use, and were conscious that help seeking for minor symptoms might put their masculinity up for scrutiny. In their discussions men emphasised the importance of: having endured symptoms to some acceptable threshold; having physical and visible symptoms; and the influence of others (particularly spouses) in their decisions about help seeking. This mirrors findings from other research […].
Robertson has considered the prospect of changing men’s attitudes to consulting, and cautions that this should not rely too heavily on promoting men’s health through female relatives as this serves “reinforce the impression that real men are not concerned about health matters”. He argues that, rather than men being unwilling to go to the doctor, they may “need a means of legitimising their visit so that they can maintain face, or keep their male identity intact, by claiming to be pressured into attending” ([…]).
The few examples of help seeking provided by younger participants emphasised how their symptoms derived from acceptably masculine pursuits. As one stated:
the only time I have (gone) to hospital or seen a doctor…was when I had been punched in the face (and)…I needed stitches or a relative tells you that you’ve got to go… even then I’ve been reluctant to go, it’s other people…tells you ‘you’ve got to go and get that seen to’ (Aidan, Student Group).
He related this reluctance to “the whole idea about what constitutes a man. A real man puts up with pain and doesn’t complain”. He, like others, reinforced his reluctance to consult by stating “I’m not even registered
[with a GP practice]”.
Men in the Health Change Group shared similar beliefs and explained in more detail why they considered the ability to endure pain or illness to be a key practice of masculinity, one that would be seriously undermined
by help seeking before a problem reached an acceptably ‘serious’ stage:
Steve: You don’t like to make a fuss because it’s a macho thing just to say you’re being the strong silent type… You’ll endure it, you can take it. So if there is something wrong you won’t talk to anyone about it. You have to be bed-ridden or half dead before you’ll go (to the doctor’s).
RO: Why would you leave it until that stage?
Steve: That’s what being a man is
Ross: Aye. You can’t really describe it. But most guys are like that.
Health Change Group
Similarly, a discussion in the Slimming Group revealed similar beliefs that men should endure illness and injury as a mark of masculinity:
Rory: I broke my thumb and it took me two days before I went to see a doctor …It was going septic, going green and purple and black and I was like ‘I’m not going to bother them’.
Jake: I think that’s just a male trait.
Nathan: Aye it’s (puts on very deep voice) ‘I am man the hunter’. I think it’s that.
Rory: I don’t even think it’s that…It’s just I couldnae [sic] go to the doctor’s with that.
Nathan: If a woman cut themselves they’d be away to the doctor. A guy’d be like ‘I’ll just go and get myself a bit of Sellotape and wrap it up’.
Rory: Aye. I put a bit of a tape on it and carried on.
Nathan: That’s just a man thing though isn’t it
Rory: Aye that’s just a man thing. ‘I’m hard, I’m daft, I’ll cut my arm off and just grow another one back’.
Many described tolerating ‘minor’ symptoms in this way. However, there was considerable elasticity in what men understood by ‘trivial’ and how much they were willing to tolerate before seeking help. While some like
George were describing “normal aches and pains, a sore throat” when they spoke about ‘trivial’ complaints (George, Prostate Cancer Group), others framed most things as ‘trivial’. When one participant was asked how he decided what was or was not trivial he responded: “you wait ‘til you take a heart attack” (Nathan, Slimming Group); another constructed symptoms as trivial “unless you’re dying” (Jake, Slimming Group). Thus, there was not only the suggestion that participants were describing delaying or avoiding treatment for ‘minor’ symptoms, but also that serious symptoms might be trivialised (or overlooked) in order to avoid challenges to masculinity.
Some participants seemed to test the limits of their masculinity through their ability to withstand severe symptoms that appeared to require urgent attention. The presence or absence of pain was seen as a key indicator of an underlying problem. One man articulated this by saying “you’re always defining what ill health is by being in physical pain” (Steve, Health Change Group). Some believed that it was ‘manly’ to tolerate a high degree of pain and distinguished between levels of pain. Ross describes ‘real pain’ as:
Basically something that will stop you doing something. It’s not the case of ‘oh, I’ve got a wee sort of twinge’. You probably won’t see a doctor if you’ve got a wee twinge. It probably won’t stop you doing things so you tend not to mention it. Ross, Health Change Group
Paul described postponing getting help until his pain was unbearable.
I’d basically pulled a muscle in my groin and he (doctor) said just rest it… I waited four days and I called him back and I was in absolute agony. He (said) ‘why didn’t you say anything?’ and I was like… ‘You told me to rest it’. The ambulance had to come…I was in absolute agony…almost in tears before I called him again. Paul, Health Change Group
Thus, it seemed that when it came to ‘minor’ symptoms the majority of participants agreed that men ‘‘should be able to push things further” (Ross, Health Change Group) before taking any action.”
O’Brien, Rosaleen, Kate Hunt, and Graham Hart. 2005. “‘It’s Caveman Stuff, but that is to a Certain Extent How Guys Still Operate’: Men’s Accounts of Masculinity and Help Seeking.” Social Science & Medicine 61:503–516.