It's a cliché that men don't like to visit the doctor. But unlike tropes about refusing to ask for directions or put away their laundry, this one has serious health ramifications.
It's a fact that men are less likely than women to get preventive screenings, seek timely medical care or be vaccinated for COVID-19 or the flu. Men also have shorter life spans than women.
Although reasons for the life expectancy gap are complex, biology explains only part of it, said Wizdom Powell, director of the UConn Health Disparities Institute in Hartford, Connecticut.
"There's something social happening," said Powell, who also is an associate professor of psychiatry at UConn Health. She and other researchers who have looked at why men avoid the doctor often focus on stereotypical concepts of masculinity.
Mary Himmelstein, an assistant professor in the department of psychological sciences at Kent State University in Ohio, said men often think acknowledging pain or seeking help means "someone's going to take my 'man card' away from me."
Many men who are providers for their families take that role seriously and say they don't want to take time off work to get medical care. So a clinic might extend operating hours to nights and weekends to accommodate them.
That means not only are they reluctant to visit a doctor when they're sick or injured, they might not communicate honestly once there. Men believe, "I have to put on this front, and I have to be consistently strong. I can't be seen as weak. I can't be seen as emotional. Because if I am, I'm going to lose social status," Himmelstein said.
The problem is consistent among age groups, she said, although it tends to taper off as men get older and their health problems mount.
Not all men think in this super-masculine way, Himmelstein said, but those who do are most at risk.
Powell agreed. "The messages 'take it like a man,' 'boys don't cry,' 'walk it off,' and 'soldier on' are things that some men internalize with a particular level of rigidity."
Broader factors also are at play, Powell said. From the onset of puberty, the health care system encourages women to see doctors regularly. "So they get a kind of early-life health socialization that boys and men are often not privy to, except in instances when boys play organized sports, and they have to get a physical."
Men also tend to have higher levels of mistrust in the medical system, she said, and people who mistrust doctors are less likely to seek care.