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. Author manuscript; available in PMC: 2024 Jan 19.
Published in final edited form as: Psychol Men Masc. 2019 Apr;20(2):161–165. doi: 10.1037/men0000210

The Physical Health of Men and Boys: Integrating Biomedical and Psychological Science

Mike C Parent 1, Francisco J Sánchez 2
PMCID: PMC10798811  NIHMSID: NIHMS1913824  PMID: 38249571

Abstract

Rigid adherence to traditional male norms has been found to be associated with many health outcomes. This special issue aims to bring together biomedical and psychological researchers as a means to generate interest in integrating scientific approaches so as to advance the health of men and boys. In this guest editorial, the authors first provide a brief review of some key biological factors that contribute to sex differences in health. The editorial then introduces the ten articles included in this special issue, which focus on paternal influence on health-related behaviors; cancer; reproductive and sexual health; eating disorders; and health-related beliefs. Ultimately, by continuing to work across disciplines, those interested in the psychological study of men and masculinities can assist biomedical researchers in promoting better health outcomes.

Keywords: bench to bedside, gender-based medicine, integrated behavioral health, team-based care, translational science

Sex1 matters. That is, whether we are classified as male or female can have far-reaching effects—from the way we are treated in society to the diseases to which we are susceptible. Although this statement may seem obvious, emphasizing the importance of sex to health was sufficiently important that the National Academy of Medicine (NAM; formerly the Institute of Medicine, 2001) published a formal report focused on this topic at the beginning of the new millennium. At that time, major scientific advances were being made (e.g., the Human Genome Project), and it became evident that overlooking or ignoring sex in biomedical research was potentially leading to misinterpreted findings. Thus, the NAM urged scientists to study sex differences in health, disease processes, and well-being.

This idea may seem antithetical to many of the values upon which Division 51 and its journal (Psychology of Men and Masculinities [PMM]) were founded. Historically, studies that focused on group differences (e.g., race, ethnicity, nationality, and religion) have at times been used to promote discriminatory practices (Guthrie, 2004; Hyde, 2014). Recent events (e.g., the #MeToo Movement) further demonstrate how patriarchal social systems continue to be used to oppress women and other historically marginalized groups (O’Neil, Sojo, Fileborn, Scovelle, & Milner, 2018). Highlighting sex differences versus sex similarities may therefore seem out of place for a special issue of PMM.

Yet, in conceiving this special issue, we wanted to bring together biomedical and social scientists whose work focused on translating studies on sex differences into preventive, diagnostic, and therapeutic practice with the aim of positively affecting outcomes and improving men’s health. Very few reputable outlets are available for this type of work (e.g., Journal of Men’s Health and Biology of Sex Differences). However, articles in those journals rarely examine how the social construction of masculinities is related to well-being. Within APA journals, only one special issue has focused on how male norms affect different aspects of physical health: the January 2013 issue of Health Psychology (Gough, 2013), yet less than a third of those articles intentionally included aspects of masculine norms in their study design (e.g., Hoyt, Stanton, Irwin, & Thomas, 2013; Sánchez, Bocklandt, & Vilain, 2013). Consequently, we decided to develop this idea for a special issue of PMM.

The final collection of ten articles for this special issue range from a theoretical article to an intervention study. Before discussing how these fit within the existing scientific base of this journal, we provide a brief review of biological factors that contribute to sex differences and that likely affect men’s well-being. Given that PMM has historically focused on psychosocial and cultural influence of gender norms, we refer readers to previous publications that provide some background in those nonbiological areas (Addis, Mansfield, & Syzdek, 2010; Vandello & Bosson, 2013). We end with some hope for future directions as PMM continues to establish itself as a key journal within science.

Sex Differences: From Womb to Tomb

From the moment of fertilization, the chromosomal complement that humans inherit will have profound effects throughout the life course. With few exceptions (Barseghyan, Délot, & Vilain, 2018), those who inherit an intact XX chromosomal complement will develop as females and those who inherit an intact XY chromosomal complement will develop as males. For the first few weeks of development, females and males are indistinguishable.

Approximately 6 to 7 weeks into development, a dramatic series of events occur as a result of the presence or absence of an intact Y chromosome. Genes on the Y chromosome will induce the neutral gonads to develop into testes that will then begin to produce biomolecules (chiefly testosterone) at levels necessary for the development of the internal reproductive tract, external genitalia, and neurodevelopment that are characteristic of males. In the absence of the Y chromosome, those who inherited an intact XX chromosomal complement will trigger the neutral gonads to develop into ovaries that will produce changes that are characteristic of females. This primary surge of gonadal hormones in utero, coupled with the surge of hormones at puberty, play a significant role in the physical differences that we generally see between females and males (see Berenbaum & Beltz [2011] and Capel [2017] for more information).

Apart from the obvious physical differences—specifically the reproductive organs—sex differences also arise in the occurrence of diseases beyond those that are only anatomically possible in either cisgender females or cisgender males (e.g., ovarian cancer and prostate cancer). For instance, females are far more affected by autoimmune diseases (e.g., systemic lupus erythematosus and Sjogren’s syndrome) compared with males, with rates as high as 9:1 (Ngo, Steyn, & McCombe, 2014). On the other hand, far more males are affected by autism spectrum disorders, color blindness, and Parkinson’s disease compared with females (Hanamsagar & Bilbo, 2016).

Yet, not all observed sex differences in physical health arise from biology alone. For instance, larynx cancer, hypopharyngeal cancer, and lip cancer occur in men at significantly higher rates than women (Dorak & Karpuzoglu, 2012), and the primary risk factor is lifestyle choices. Consequently, both basic biology and environmental factors work interactively to influence health behaviors as they pertain to sex and gender.

How might the socialization of boys and men contribute to these factors? How might masculine norms influence occupational choices and health-related behaviors that put their health at risk? How can we tailor interventions for men in ways that do not threaten their sense of self? It is these types of questions that we hoped to advance in this special issue.

This Special Issue of PMM

The NAM proposed several recommendations to promote our scientific understanding of what factors contribute to the health of women and men (Institute of Medicine, 2001). Within their recommendations, the NAM encouraged interdisciplinary research on sex differences, including the need for collaboration between biomedical scientists and social scientists. That is, the social construction of gender directly and indirectly affects many aspects of health. This includes social hierarchies and systems of power, activities that people engage in, occupational hazards, exposure to toxins, and access to health care. All of these factors, which vary cross-culturally and over time, can influence sex differences. Thus, social scientists can provide their expertise alongside biomedical scientists to expand the existing knowledge base in ways that ultimately promote health and well-being as it relates to sex and gender.

Division 51 and its journal seem well situated to help in such collaborations. Since its founding in 2000, PMM has focused on how masculinity ideologies influence the psychological well-being of boys and men. Much of this work emanated from the work of social scientists and mental health practitioners that had been highlighting ways in which male gender role socialization can be detrimental for both men and women (David & Brannon, 1976; Pleck, 1981). Several analyses of articles published in PMM highlighted the common themes and the most impactful works, which have focused on gender norms, gender role strain, gender role conflict, and male body image (Parent et al., 2018; Sánchez, 2010, 2015; Wong, Steinfeldt, Speight, & Hickman, 2010). These articles, along with editorials by Levant (2008, 2014), have urged finding ways to promote submissions of article focused on biomedical and physical health topics so as to broaden the impact of the journal’s work and integrate the psychology of men and masculinities into medical and health science. In fact, the examples listed as relevant topics for PMM currently includes “biological factors influencing male development” (see journal description on the inside cover of the current issue).

Consequently, there has been a slight increase in the number of research reports published in PMM that have incorporated biological variables and biomedical measures. For instance, recent studies have included blood pressure (Kline, 2018), salivary cortisol (Himmelstein, Kramer, & Springer, 2018), and body mass index (Frederick & Essayli, 2016). Yet, far more needs to be done to advance the physical health of men and boys and to integrate social science with medical science, which Tsang, Hamilton, and Wassersug (2019) argue for in this issue. In addition to their article, we expand this growing body of literature in specific areas, which we highlight next.

Paternal Influence on Health-Related Behaviors

A critical role that many men play is that of being a father, and father–son relationships can influence many health-related behaviors. Two studies in this issue focus on how the quality of these relationships is associated with son’s body mass index (Coleman, O’Neil, Caldwell, & Ferris, 2019) and how fathers’ eating habits may be influenced by their son’s experiences of discrimination—perhaps as a form of coping (Coleman, O’Neil, & Ferris, 2019). These articles follow the growing number of PMM articles that have been focusing on the importance of fathers’ involvement in childcare (Kuo, Volling, & Gonzalez, 2018; Lee & Lee, 2018; Trahan, 2018), the psychological challenges of fatherhood (Sockol & Allred, 2018; Zerach & Magal, 2017), the need for fathers to focus on self-care (Nash, 2018; Rominov, Giallo, Pilkington, & Whelan, 2018), and the experience of being a father among non-Western men (Barrocas, Vierira-Santos, Paixão, Roberto, & Pereira, 2017; Kasymova & Billings, 2018). Indeed, fatherhood was identified as a growing area of interest in PMM’s publication profile, and as an area of inquiry potentially fruitful for grant-funded research (Parent et al., 2018).

Cancer

At least a third of the population will be diagnosed with cancer at some point during their lifetime. A few studies published in PMM have shown how masculine norms impede cancer screening (Christy, Mosher, Rawl, & Haggstrom, 2017; Rivera-Ramos & Buki, 2011) and create barriers to seeking help for a cancer diagnosis (Fish, Prichard, Ettridge, Grunfeld, & Wilson, 2019). Three more articles related to cancer are in this issue, building on this crucially relevant health outcome.

The first two articles focus on lifestyle choices, which often play a significant role in developing certain preventable cancers. For instance, smoking is the most common cause of lung cancer (U.S. Department of Health & Human Services, 2014). Although many smokers report wanting to quit, success rates are mixed even when they seek professional help versus trying to quit on their own (Wu, Wilson, Dimoulas, & Mills, 2006). Bottorff et al. (2019) present a novel intervention that is tailored specifically for fathers. The results of their 8-week program are promising and could potentially have far-reaching effects, given the influence that fathers’ behaviors have on their children.

Another lifestyle choice that contributes to cancer is the intentional exposure to excessive ultraviolet radiation. Nogg, Lamb, Rooney, and Blashill (2019) provide the first published data related to tanning dependence among a group of sexual-minority men, which is of significant importance for public health, given that skin cancer is the most common type of cancer in the United States. They highlight the need for further research on the precursors to tanning dependence to better tailor prevention efforts, including ways in which this preventable disease intersects with sexual minority status.

The third article focuses on prostate cancer. Given the adverse impact that this type of cancer has on men’s sexual functioning, Tsang, Skead, Wassersug, and Palmer-Hague (2019) conducted a content analysis of 42 peer-reviewed articles to glean what aspects of masculinity patients reported as being affected. Interestingly, their analysis highlighted the potential problems with measurement error and researcher bias in terms of how masculinity is constructed, highlighting the importance of integration of social science and medical/health science.

Reproductive and Sexual Health

Very few studies have looked at how masculine norms influence the use of contraception (Terry & Braun, 2013) and sexual health (Parent, Torrey, & Michaels, 2012). Here we include two studies that address these issues.

First, most technologies focused on preventing pregnancy place the burden of this responsibility on females (e.g., birth-control pills, intrauterine devices, and tubal ligation; Fennell, 2011; Kimport, 2018), with many of these having far more adverse side effects and complications compared with the few options available for men (i.e., condoms and vasectomies). Previous articles in PMM have linked traditional gender role behavior with condom use (Locke, Newcomb, & Goodyear, 2005), but in this issue, Peterson, Campbell, and Laky (2019) examined how men feel about the idea of pursuing hormonal contraception for men—a medical innovation currently being developed (Behre et al., 2016). They found that gender norms may influence men’s willingness to pursue such interventions should they ever reach the market—again, clearly emphasizing the importance of the integration of work on gender role socialization and medical interventions.

Second, an important aspect of sexual health is routine screening for sexually transmitted infections, especially among high-risk groups. Dillon et al. (2019) found that desire to conform to masculine norms may inhibit Latino men who have sex with men to be tested for HIV. This finding reinforces the idea that public health campaigns should be tailored in ways that do not threaten men’s sense of self (Parent et al., 2012), and speaks to the applicability of some of PMM’s primary theoretical and measurement tools being applicable directly to the physical health of minority populations.

Eating Disorders

Several studies in PMM have focused on body image issues among men. Most of these are related to muscularity and body dysmorphic disorder (Brewster, Sandil, DeBlaere, Breslow, & Eklund, 2017; Edwards, Molnar, & Tod, 2017). Less known is how eating disorders manifest among adolescents. In this issue, Blazek and Carter (2019) studied how the interaction between racial identity and gender identity with pubertal timing contributed to disordered eating behaviors among a sample of Black adolescents. Their results offer a complex picture of developmental trajectories of disordered eating at the intersections of gender, race, and age.

Health-Related Beliefs

Rigidly conforming to traditional male roles can be hazardous to men’s health (Bradstreet & Parent, 2018). Numerous studies have found that the greater that men value and are concerned with masculine norms, the less likely they are to report engaging in healthy behaviors (Whitley, Madson, & Zeigler-Hill, 2018; Zamboanga, Audley, Iwamoto, Martin, & Tomaso, 2017). Even more concerning is that there is a negative association between valuing traditional masculinity and openness to seeking help when needed (Heath, Seidman, Vogel, Cornish, & Wade, 2017; McDermott et al., 2018). In this issue, Salgado, Knowlton, and Johnson (2019) further this line of research by reporting the degree to which conformity to masculine norms predicted both health protective and health risk behaviors among a sample of young men. Their findings further illustrate how healthcare providers could benefit by a better appreciation for how masculine norms adversely affect boys and men.

Advancing the Physical Health of Men and Boys

Sex is a fundamental variable that should be considered when engaging in health-related research. At the same time, social factors should not be overlooked. Division 51 and PMM can, therefore, play a critical role in advancing the physical health of men and boys.

In this special issue, we have provided examples for the kind of research that we hope will be furthered within our field of study. We encourage readers to find ways to both engage with existing biomedical studies and to initiate interdisciplinary collaborations that incorporate measures of masculine norms alongside biomedical measures so that a more complete understanding can be made of the health of men and boys. Furthermore, we especially encourage studies that can focus on underrepresented groups in men’s health, including transmen, men with disabilities, and men with disorders of sex development. We hope that this special issue will further promote closer collaborations between biomedical and psychological scientists to advance our understanding of how biological sex and the social construction of gender interact to affect the physical health of men and boys.

Footnotes

1

We use the term sex as typically used in biomedical science where organisms are generally classified as female or male according to specific parameters (e.g., chromosomal complement and reproductive organs).

Contributor Information

Mike C. Parent, Department of Educational Psychology, The University of Texas at Austin

Francisco J. Sánchez, Department of Educational, School, and Counseling Psychology, University of Missouri

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