How Chronic Illness and Masculinity Intersect

Source: Katie Willard Virant

What is masculinity? This is a highly personal question that deserves reflection.

What images, thoughts, and feelings enter your mind when contemplating masculinity? Perhaps you think of a muscular man boxing at the gym, or a father walking hand in hand with his child, or a businessperson in a suit, or a carpenter working on a project.

You may remember times in your life when your identity felt congruent with being male. You may also remember times when you believed you were not male enough. What messages about masculinity have you received from your family of origin, your peers, and society? For example, have you been told that “boys don’t cry”? Which of these messages do you personally accept and reject?

The Intersection of Masculinity and Chronic Illness

Men experience chronic illness in ways that intersect with masculinity. Researchers identify four main areas of intersection: physicality, sexuality, socio-cultural roles, and emotionality (Salifu, Almack & Caswell, 2023).

I want to stress that changes caused by chronic illness are devastating in and of themselves. However, for men, there can be an additional layer of pain in that these changes implicate what they see as their male identity.

• Physicality: Changes in the body due to illness can cause men to feel less masculine. Loss of muscle, weakness, and fatigue are difficult for many reasons; for men, however, these symptoms can be overlayed with a shame that their bodies make them less of a man.
• Sexuality: Loss of sexual function and/or libido causes many men to feel that they’ve lost their maleness. For many men, having sexual intercourse is fundamental to being a man. To lose function or desire, then, is to lose gender identity.
• Socio-cultural roles: For many men, providing for their families economically is central to masculinity. When chronic illness interferes with their ability to work, many men feel shame that they are not performing what they see as a central task of maleness.
• Emotionality: Chronic illness evokes feelings of vulnerability, fear, and sadness. Many men struggle with allowing and expressing those normal feelings, believing that real men should be stoic.

Effects of the Chronic Illness/Masculinity Intersection

Men who believe they have lost masculinity due to chronic illness can feel lonely, ashamed, lost, and depressed (Abboah-Offei et al., 2024). They may act in ways detrimental to their physical health in an attempt to reaffirm masculinity.

For example, they may ignore symptoms, refuse to modify activity, and even avoid treatment (Dax et al., 2022). They may isolate themselves from other men out of fear that they will be rejected (Flurey et al., 2018). They may shut down emotionally with their spouse/partner out of a belief they are no longer appealing (Salifu, Almack & Caswell, 2023).

Renegotiating Masculinity

Women have benefitted immensely from the recognition that there are many ways to be feminine. Today, a woman’s femininity is much less likely to be questioned when she plays sports, leads companies, or decides not to marry and/or bear children.

Culturally, we’ve broadened our ideas of what a woman looks like. We’ve begun the work of broadening cultural ideas of masculinity, too, but some tropes continue to be stubborn.

If you are a man living with illness, I invite you to renegotiate your ideas of masculinity. Examples include the following:

• Real men are strong. I am strong in the fortitude I show living with illness. I live with pain, uncertainty, and fear every day, and I continue to show up.
• Real men are sexual. Even if I cannot have sex, I am a sexual person. Sex is more than intercourse. I can find other ways of intimacy with my partner. I can enjoy being attracted to my partner and believe that my partner is also attracted to me.
• Real men provide for their families. Even if I can no longer provide economically for my family, I can provide emotional presence and love. I can set a good example for my children. I can be an engaged partner for my spouse. I will not abandon my family emotionally, even in this difficult time. I will take good care of my health so that I can be there for them. This is my commitment to them.
• Real men experience and express feelings. I am allowed to feel sad, scared, and vulnerable. I am working to break down barriers that separate men from their feelings. In expressing my feelings, I’m helping change the rules so that today’s boys will have it easier than I did.

Conclusion

The intersection of chronic illness and masculinity places an added burden on men living with illness. Active rejection of narrow masculine tropes and renegotiation of masculinity is essential in decreasing this burden.